Comparison of a Vibration Roller and a Nonvibration Roller Intervention on Knee Range of Motion and Pressure Pain Threshold: A Randomized Controlled Trial

Acute Effects of Foam Rolling vs. Vibration Foam Rolling on Blood Flow Parameters in Professional Soccer Players: A Randomized Crossover Design

ABSTRACT

Padrón-Cabo, A, Alonso-Calvete, A, Radzimiński, Ł, Rey, E, and Lorenzo-Martínez, M. Acute Effects of foam rolling vs. vibration foam rolling on blood flow parameters in professional soccer players: a randomized crossover design. J Strength Cond Res 38(11): 1885-1890, 2024-The study aimed to compare the effects of foam roller (FR) and vibration foam roller (VFR) on blood flow parameters, measured by Doppler ultrasonography in professional soccer players. A randomized crossover design was used, and 10 professional soccer players participated in 3 experimental sessions: FR, VFR, and a control condition (CC). The maximum velocity (MVel) and maximum volume (MVol) blood flow parameters were measured in the common femoral artery of the dominant leg at 5 different time points as follows: before (pre), immediately after (post 0'), 10 (post 10'), 20 (post 20'), and 30 minutes (post 30') after the intervention. Both FR and VFR involved two 45-second sets with 15-second rest between sets in the quadriceps and hamstring, while CC required sitting for 240 seconds. The FR condition showed a significant increase in MVel ( p < 0.01) at all time points after the intervention, and an increase in MVol ( p < 0.05) only at post 0' compared with pre. The VFR condition showed a significant ( p < 0.05) increase in MVel at post 0' and post 10' and an increase ( p < 0.05) in MVol at post 0' compared with pre. In comparison with CC, the FR and VFR conditions presented significantly ( p < 0.05) higher MVel values at post 0', post 10', post 20', and post 30' than CC. For both FR and VFR conditions, the MVol not only revealed a significant ( p < 0.05) increase at post 0' but also at post 10' for VFR compared with CC. In summary, the FR and VFR interventions demonstrated a similar increase in blood flow parameters, suggesting that both strategies may accelerate physiological recovery in elite soccer players.

Impact of foam rolling with and without vibration on muscle oxidative metabolism and microvascular reactivity

Background and Purpose

There is a growing interest in use vibration foam rolling as a warm up and recovery tool. However, whether vibration foam rolling offers additional benefits to traditional foam rolling is unclear. The current study aims to compare the effects of acute foam rolling, with and without vibration, on skeletal muscle metabolism and microvascular reactivity.

Methods

Fifteen physically active young males were tested on two different days, with gastrocnemius muscle microvascular function assessed using near-infrared spectroscopy coupled with the post-occlusive reactive hyperemia technique, before and after foam rolling, performed with or without vibration. The slope of tissue saturation index (TSI) decrease during occlusion between 120 s to 150 s (TSI occlusion slope) was assessed for muscle metabolic rate. Three commonly used microvascular function indexes, including the first10s TSI slope after occlusion (TSI10), time for TSI to reach half of peak magnitude (TSI1/2), and TSI peak reactive hyperemia, were also assessed.

Results

None of the measured indexes showed significance for interaction or method (all p > 0.05). However, there was a main effect for time for TSI occlusion slope, TSI1/2, and TSI peak reactive hyperemia (p = 0.005, 0.034 and 0.046, respectively). No main effect for time for TSI10 was detected (p = 0.963).

Conclusions

The application of foam rolling can decrease muscle metabolism, and may improve some aspects of muscle microvascular function. However, vibration foam rolling does not seem to offer any additional benefits compared to traditional foam rolling alone.

Effects of Foam Rolling Prior to Proprioceptive Neuromuscular Facilitation Stretching on Hamstring Flexibility and Thigh Skin Temperature

CONTEXT

Proprioceptive neuromuscular facilitation stretching (PNFS) is suggested to improve the range of motion and flexibility as an active warm-up. Recently, the foam rolling (FR) methods have also emerged as a passive warm-up. However, the combined effects of PNFS and FR are still unclear, and no reports have compared their effects using thermal imaging. This study investigated the acute effects of combining nonvibration FR (NVFR) and vibration FR (VFR) prior to PNFS, in comparison with PNFS alone, on hamstring flexibility and thigh skin temperature.

DESIGN

Randomized controlled trial.

METHODS

Participants (n = 60) were randomly assigned to PNFS, NVFR + PNFS, VFR + PNFS, and control group (CG). Active knee-extension (AKE), sit and reach (SR) test, and thermal imaging were evaluated before (pre-int), immediately after (post-int), and 30-minutes after (post30-int) intervention.

RESULTS

All intervention groups had a significant increase at all time periods (P < .001) except the CG in terms of AKE and sit and reach test (P > .05). Combined (NVFR + PNFS/VFR + PNFS) groups had also a significant increase in the post30-int compared with pre-int and post-int values of thigh skin temperature (P < .001). Combined groups, over time, had the best post30-int effect on increasing skin temperature. The study found a significant interaction effect between interventions and time across several measurements (P < .05). Combined groups showed more significant improvements in AKE compared to CG at post-int (P < .05). There is a similar change in AKE, SR test, and skin temperatures between combined groups and PNFS alone at both post-int and post30-int (P < .05).

CONCLUSIONS

These findings indicate that using FR, with or without vibration, before PNFS does not provide an additional benefit in improving hamstring flexibility and thigh skin temperatures compared with PNFS alone.

Acute Effects of Handheld Vibration Massage on Posterior Shoulder Soft Tissues

Background

Interventions using vibration stimulation have been recognized for their potential for increasing range of motion (ROM) without compromising muscle strength. Handheld vibration massagers can efficiently deliver vibration therapy to the shoulder joint and may be a potential treatment.

Purpose

To evaluate the effects of vibration massage using a handheld device on the soft tissues of the posterior shoulder joint, particularly on internal rotation (IR) passive ROM and external rotation (ER) muscle strength.

Study Design

Crossover study design.

Methods

A crossover study with a 5-min vibration massage and passive control condition was conducted in healthy male volunteers (mean age 20.5 ± 1.7 years). Vibration massage was applied to the posterior shoulder soft tissues of the dominant arm, with no intervention under control conditions. IR-ROM (vertebral level and in abduction) and strength of the external rotators (isometric and isokinetic) were measured before and immediately after the intervention. Vertebral levels were calculated as a ratio of lengths (ratio decreases with increased mobility). IR-ROM in abduction, the angle was measured. Statistical analysis was performed with two-way repeated measures ANOVA and paired t-test (Bonferroni correction).

Results

Vibration application decreased (improved) vertebral level IR ROM by -4.1% (p < 0.01, d = 0.445) and increased abduction position IR ROM by 11.4° (p < 0.01, d = 0.694). These changes exceeded the 95% confidence interval for the minimum detectable change. By contrast, the control condition produced no changes. IR-ROM (vertebral level and abduction) immediately after the intervention showed significant differences between the control and vibration conditions (p = 0.036, d = 0.273; p = 0.048, d = 0.483, respectively). Muscle strength did not show any interaction, time, or between-condition effects.

Conclusions

A massage using a handheld vibration massager applied to the posterior shoulder soft tissues increased IR-ROM without negatively affecting muscle strength, suggesting its potential use as a means of warming up.

Level of Evidence

Level 3.

The Acute Effects of Cold Water Immersion and Percussive Massage Therapy on Neuromuscular Properties and Muscle Soreness after Exercise in Young Male Soccer Players

Cold water immersion (CWI) and percussive massage therapy (PMT) are commonly used recovery techniques in team sports. In particular, despite its wide use, PMT has been scarcely investigated in the literature, especially regarding neuromuscular measures and in comparison with other techniques. This study aimed to evaluate and compare the acute and short-term effects (24 h) of CWI and PMT on muscle strength, contractile properties, and soreness after exercise. A randomized crossover study was performed on sixteen male soccer players (22 years, 20-27) who participated in three experimental sessions involving a fatiguing protocol consisting of a Yo-Yo Intermittent Endurance Test followed by 3 × 10 squat jumps and a wall sit for 30 s, and 12 min of recovery including CWI (10 °C water), bilateral PMT on the anterior and posterior thigh, or passive resting. Outcomes were assessed immediately after the exercise protocol, after the recovery intervention, and at 24 h. Isometric knee extension (IKE) and flexion (IKF) and tensiomyography (TMG) were assessed. Muscle soreness and fatigue were scored from 0 to 10. PMT increased strength after the treatment (p = 0.004) and at 24 h (p = 0.007), whereas no significant differences were found for the other two recovery modalities. At post-recovery, compared to CON, CWI resulted in a longer TMG contraction time (p = 0.027). No significant differences were found at 24 h. Finally, PMT and CWI enhanced muscle soreness recovery compared to passive rest (F4,60 = 3.095, p = 0.022, pη2 = 0.171). Preliminary results from this study suggest that PMT might improve isometric strength after strenuous exercise, and both PMT and CWI reduce muscle soreness perception, while the effects on TMG parameters remain controversial.

Self-Massage Acute Effects on Pressure Pain Threshold, Muscular Electrical Activity, and Muscle Force Production: A Systematic Review and Meta-Analysis

ABSTRACT

Furlan, MR, Machado, E, Petter, GdN, Barbosa, IM, Geremia, JM, and Glänzel, MH. Self-massage acute effects on pressure pain threshold, muscular electrical activity, and muscle force production: a systematic review and meta-analysis. J Strength Cond Res 38(3): 620-635, 2024-Self-massage (SM) is often used in physiotherapy and sports training programs. However, the SM acute effects on pressure pain threshold (PPT), muscle electrical activity (MEA), and muscle force production remain unclear. A meta-analytical review was performed to verify the SM acute effects on neuromuscular responses in healthy adults or athletes. The review (CRD42021254656) was performed in the PubMed, Web of Science, and Embase databases. A synthesis of the included studies was performed, and both the risk of bias and the evidence certainty level were assessed through the PEDro scale and Grading of Recommendations Assessment, Development, and Evaluation approach, respectively. Nineteen studies were included, 5 evaluated the PPT, 7 the thigh muscles' MEA, and 15 the lower-limb strength. The SM application induces moderate increases in quadriceps' PPT (5 studies; standardized mean difference [SMD]: 0.487; 95% CI 0.251-0.723; p < 0.001; I2 = 0%). We found no SM effects on the hamstrings and plantar flexors' MEA. Also, we observed small increases in knee extensors' concentric torque (2 studies; SMD: 0.288; 95% CI 0.088-0.489; p = 0.005; I2 = 0%), without effects in isometric muscle strength, eccentric torque, and rate of force development. Grading of recommendations assessment, development, and evaluation analysis showed high and low certainty levels for the SM effects on quadriceps' PPT and muscle strength, respectively. Self-massage pressure-volume application seems to be a determining factor in inducing changes in these parameters, and it may vary among the treated muscles, where a higher pressure-volume application is required for increasing knee flexors and plantar flexors' PPT and strength. Thus, new studies with better methodological quality should be performed to strengthen this evidence.

Effects of percussion massage therapy, dynamic stretching, and static stretching on physical performance and balance

BACKGROUND

Percussion massage therapy is a popular approach in sport medicine for physical therapists, but few researchers have investigated the comparison with other intervention methods.

OBJECTIVE

This study aimed to examine the comparison of the effects of dynamic stretching, static stretching and percussive massage therapy on balance and physical performance in individuals.

METHODS

The participants who were 18-25 years of age, able to perform performance tests, did not have any orthopedic surgery, did not have problems during running and sudden turning, and did not have a professional sports history were included in the study. Participants were assigned randomly to three groups as dynamic stretching (DS) (n= 16), static stretching (SS) (n= 16) and percussive massage therapy (PMT) (n= 16) groups. Horizontal jumping test, T drill test and balance measurements on a single leg with open and closed eyes of all participants were recorded before and after applications.

RESULTS

When the values of the pre and post-treatment of all groups in the study were compared, significant improvements were observed in the t-test, horizontal jumping test and right/left foot balance with eyes open in DS group (p< 0.05). Significant improvements were observed in all values in the PMT group (p< 0.05). In the comparison of the differences between the groups, PMT group values were more significant than the SS group in all parameters.

CONCLUSION

Percussive massage therapy would be an alternative that can be used to increase the performance and balance of individuals before exercise.

Self-Massage Techniques for the Management of Pain and Mobility With Application to Resistance Training: A Brief Review

ABSTRACT

MacLennan, M, Ramirez-Campillo, R, and Byrne, PJ. Self-massage techniques for the management of pain and mobility with application to resistance training: a brief review. J Strength Cond Res 37(11): 2314-2323, 2023-Fascial restrictions that occur in response to myofascial trigger points (MTrP), exercise-induced muscle damage (EIMD), and delayed onset of muscle soreness (DOMS) cause soft tissue to lose extensibility, which contributes to abnormal muscle mechanics, reduced muscle length, and decrements in joint range of motion (ROM) and actively contributes to musculoskeletal pain. Resistance training and in particular, weightlifting movements have unique mobility requirements imperative for movement efficacy and safety with ROM restrictions resulting in ineffective volume and intensity tolerance and dampened force output and power, which may lead to a failed lift or injury. Self-massage (SM) provides an expedient method to promote movement efficiency and reduce injury risk by improving ROM, muscular function, and reducing pain and allows athletes to continue to train at their desired frequency with minimal disruption from MTrPs-associated adverse effects. Thus, the aim of this review was to determine the efficacy of various self-massage tools in managing pain and mobility and to explore the potential benefits of SM on resistance training performance. Many SM devices are available for athletes to manage ROM restrictions and pain, including differing densities of foam rollers, roller massagers, tennis balls, and vibrating devices. To attenuate adverse training effects, a 10-to-20-minute bout consisting of 2-minute bouts of SM on the affected area may be beneficial. When selecting a SM device, athletes should note that foam rollers appear to be more effective than roller massagers, with vibrating foam rollers eliciting an increased reduction to pain perception, and tennis balls and soft massage balls were shown to be efficacious in targeting smaller affected areas.

The Effects of Massage Guns on Performance and Recovery: A Systematic Review

The use of massage guns has become increasingly popular in recent years. Although their use is more and more common, both in a clinical and sports context, there is still little information to guide the practitioners. This systematic review aimed to determine the effects of massage guns in healthy and unhealthy populations as pre- and post-activity or part of a treatment. Data sources used were PubMed, PEDro, Scopus, SPORTDiscus, Web of Science and Google Scholar, and the study eligibility criteria were based on "healthy and unhealthy individuals", "massage guns", "pre-activity, post-activity or part of a treatment" and "randomized and non-randomized studies" (P.I.C.O.S.). Initially, 281 records were screened, but only 11 could be included. Ten had a moderate risk of bias and one a high risk of bias. Massage guns could be effective in improving iliopsoas, hamstrings, triceps suralis and the posterior chain muscles' flexibility. In strength, balance, acceleration, agility and explosive activities, it either did not have improvements or it even showed a decrease in performance. In the recovery-related outcomes, massage guns were shown to be cost-effective instruments for stiffness reduction, range of motion and strength improvements after a fatigue protocol. No differences were found in contraction time, rating of perceived exertion or lactate concentration. Massage guns can help to improve short-term range of motion, flexibility and recovery-related outcomes, but their use in strength, balance, acceleration, agility and explosive activities is not recommended.

Comparison Between Foam Rolling With and Without Vibration on Passive and Active Plantar Flexor Muscle Properties

Although foam rolling interventions with and without vibration have been used to increase flexibility in the field of sports, their effects on passive and active properties remain unclear. Hence, this study aimed to investigate the effects of foam rolling interventions on range of motion (ROM), shear elastic modulus, plantar flexor muscle strength, and jump performance. This randomized, controlled, crossover study included 16 healthy male participants who visited the laboratory three times (control condition, foam rolling condition, and vibration foam rolling condition), each with an interval of >72 h. In both foam rolling and vibration foam rolling conditions, participants were instructed to perform 60-s bouts of intervention for three sets, with 30-s rest between each set. In the vibration foam rolling condition, the intensity of vibration was set at a frequency of 48 Hz. Dorsiflexion (DF) ROM, shear elastic modulus, plantar flexor muscle strength, and drop jump height were determined before and after the rolling intervention. Our results showed a similar increase in DF ROM (p < 0.01, d = 0.51; p < 0.01, d = 0.65, respectively) and passive torque at DF ROM (p = 0.02, d = 0.51 and p < 0.01, d = 0.65, respectively) after foam rolling and vibration foam rolling. Medial gastrocnemius shear elastic modulus decreased only after vibration foam rolling (p < 0.01, d = 0.44). No significant main effects of time were observed in maximal voluntary isometric contraction torque (F = 2.0, p = 0.15, η_p² = 0.119) and drop jump height (F = 1.5, p = 0.24, η_p² = 0.091) after both interventions. Maximal voluntary concentric contraction torque showed a significant main effect of time (F = 7.59, p = 0.02, η_p² = 0.336). However, only after foam rolling, the maximal voluntary concentric contraction torque significantly decreased (p = 0.01, d = 0.39). Our results suggest that vibration foam rolling effectively alters passive muscle properties without decreasing muscle strength and performance.

Comparison of A Single Vibration Foam Rolling and Static Stretching Exercise on the Muscle Function and Mechanical Properties of the Hamstring Muscles

Knee extension and hip flexion range of motion (ROM) and functional performance of the hamstrings are of great importance in many sports. The aim of this study was to investigate if static stretching (SS) or vibration foam rolling (VFR) induce greater changes in ROM, functional performance, and stiffness of the hamstring muscles. Twenty-five male volunteers were tested on two appointments and were randomly assigned either to a 2 min bout of SS or VFR. ROM, counter movement jump (CMJ) height, maximum voluntary isometric contraction (MVIC) peak torque, passive resistive torque (PRT), and shear modulus of semitendinosus (ST), semimembranosus (SM), and biceps femoris (BFlh), were assessed before and after the intervention. In both groups ROM increased (SS = 7.7%, P < 0.01; VFR = 8.8%, P < 0.01). The MVIC values decreased after SS (-5.1%, P < 0.01) only. Shear modulus of the ST changed for -6.7% in both groups (VFR: P < 0.01; SS: P < 0.01). Shear modulus decreased in SM after VFR (-6.5%; P = 0.03) and no changes were observed in the BFlh in any group (VFR = -1%; SS = -2.9%). PRT and CMJ values did not change following any interventions. Our findings suggest that VFR might be a favorable warm-up routine if the goal is to acutely increase ROM without compromising functional performance.

Does Vibration Foam Roller Influence Performance and Recovery? A Systematic Review and Meta-analysis

BACKGROUND

Foam rolling has been extensively investigated, showing benefits in performance and recovery. Recently, vibration has been added to foam rollers, with hypothesized advantages over conventional foam rollers. However, there is no systematic evidence in this regard.

OBJECTIVE

To carry out a systematic review and meta-analysis about the effects of vibration foam roller (VFR) on performance and recovery.

METHODS

A systematic search was conducted in PubMed/MEDLINE, Web of Science and SportDiscus according to the PRISMA guidelines. The outcomes included performance (jump, agility and strength) and recovery variables (blood flow, pain and fatigue) measured after an intervention with VFR. The methodological quality was assessed with the PEDro scale. A random-effects model was used to perform the meta-analysis.

RESULTS

Initially, 556 studies were found and after the eligibility criteria 10 studies were included in the systematic review and 9 in the meta-analysis. There was no significant effects on jump performance (SMD = 0.14 [95% CI - 0.022 to 0.307]; p = 0.101; I2 = 1.08%) and no significant beneficial effects were reported on isokinetic strength (SMD = 0.16 [95% CI - 0.041 to 0.367]; p = 0.117; I2 = 9.7%). Recovery appears to be enhanced after VFR interventions, but agility does not seem to increase after VFR interventions.

CONCLUSION

This systematic review and meta-analysis suggest that VFR could have great potential for increasing jump performance, agility, strength and enhancing recovery. Further research is needed to confirm the effects of VFR on performance and recovery. Trial Registration This investigation was registered in PROSPERO with the code CRD42021238104.

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.

Expert Consensus on the Contraindications and Cautions of Foam Rolling-An International Delphi Study

Background: Foam rolling is a type of self-massage using tools such as foam or roller sticks. However, to date, there is no consensus on contraindications and cautions of foam rolling. A methodological approach to narrow that research gap is to obtain reliable opinions of expert groups. The aim of the study was to develop experts’ consensus on contraindications and cautions of foam rolling by means of a Delphi process. Methods: An international three-round Delphi study was conducted. Academic experts, defined as having (co-) authored at least one PubMed-listed paper on foam rolling, were invited to participate. Rounds 1 and 2 involved generation and rating of a list of possible contraindications and cautions of foam rolling. In round 3, participants indicated their agreement on contraindications and cautions for a final set of conditions. Consensus was evaluated using a priori defined criteria. Consensus on contraindications and cautions was considered as reached if more than 70% of participating experts labeled the respective item as contraindication and contraindication or caution, respectively, in round 3. Results: In the final Delphi process round, responses were received from 37 participants. Panel participants were predominantly sports scientists (n = 21), physiotherapists (n = 6), and medical professionals (n = 5). Consensus on contraindications was reached for open wounds (73% agreement) and bone fractures (84%). Consensus on cautions was achieved for local tissue inflammation (97%), deep vein thrombosis (97%), osteomyelitis (94%), and myositis ossificans (92%). The highest impact/severity of an adverse event caused by contraindication/cautions was estimated for bone fractures, deep vein thrombosis, and osteomyelitis. Discussion: The mechanical forces applied through foam rolling can be considered as potential threats leading to adverse events in the context of the identified contraindications and cautions. Further evaluations by medical professionals as well as the collection of clinical data are needed to assess the risks of foam rolling and to generate guidance for different applications and professional backgrounds.

The effect of self-reported knee instability on plantar pressure and postural sways in women with knee osteoarthritis

BACKGROUND

Giving way and knee instability are common problems in patients with knee osteoarthritis, disrupting the daily activities and balance of the affected individual. The present study aimed to evaluate the postural control status of women with knee osteoarthritis with and without self-report knee instability (KI).

METHODS

This cross-sectional, single-blind study was conducted on 57 female patients with knee osteoarthritis. The patients were selected based on the inclusion and exclusion criteria and divided into two groups of with KI (n = 26) and without KI (n = 31). Fear of movement was assessed using the Tampa questionnaire, the degree of knee instability was measured based on the Fitzgard scale, the static and dynamic balance of the subjects were evaluated with open and closed eyes using a Biodex balance device, and foot pressure distribution situation was measured using a FDM-S-Zebris device.

RESULTS

Mean comparison showed a significant difference between the subjects with and without KI in static balance only in anterior-posterior direction with open eyes (p = 0.01) and closed eyes (p = 0.0001). In the dynamic balance test, the subjects in both groups had significant differences in terms of all the indicators of anterior-posterior stability (p = 0.001), medial-lateral stability (p = 0.0001), and overall stability (p = 0.0001) with closed eyes. However, no significant difference was observed with open eyes (p > 0.05). Multiple regression also indicated significant positive correlations between pain intensity and disease duration with the degree of KI (p < 0.05).

CONCLUSIONS

According to the results, there were significant differences between the mean pain scores, static and dynamic balance, and the rate of fall between the women with knee osteoarthritis with and without the KI index. Therefore, patients with knee osteoarthritis, which also has an index of KI, are more susceptible to falls, and proper strategies are required to reduce the level of KI in these patients.

Acute Effects of Vibration Foam Rolling with Light and Moderate Pressure on Blood Pressure and Senior Fitness Test in Older Women

Vibration foam rolling (VR) can improve flexibility and sports performance. However, blood pressure (BP), heart rate (HR) and senior fitness test (SFT) responses induced by an acute VR session in older women are currently unknown. Fifteen healthy women (72.90 ± 4.32 years) completed three separated randomly sequenced experimental visits. During each visit, they started with a warm-up protocol (general warm up (GW): walking + static stretching (SS), SS + VR with light pressure (VRL), or SS + VR with moderate pressure (VRM)), and completed BP, HR, SFT measurements. The systolic BP increased significantly after all three warm up protocols (p < 0.05). Both VRL and VRM protocols induced statistically significant improvements (effect size range: 0.3-1.04, p < 0.05) in the senior fitness test (back scratch, 30 s chair stand, 30 s arm curl, and 8 foot up and go), as compared to the GW. In addition, the VRM showed greater improvement for the 2 min step test when comparing with the VRL. Therefore, including VR in a warm-up protocol can result in superior SFT performance enhancement than the GW does in healthy older women.

Acute Effect of Vibration Roller With and Without Rolling on Various Parts of the Plantar Flexor Muscle

A single use of a vibration foam roller likely increases the range of motion (ROM) without decreasing muscle strength and athletic performance. However, to date, no study compared the effects of a vibration roller with and without rolling on various parts of the plantar flexor muscle. Therefore, this study aimed to compare the effects of the vibration foam roller with rolling or without rolling at the muscle-tendon junction (MTJ) or the muscle belly on dorsiflexion (DF) ROM, passive torque at DF ROM, shear elastic modulus, muscle strength, and jump performance. Fifteen healthy young males performed the following three conditions: (1) vibration rolling over the whole muscle-tendon unit, (2) static vibration on muscle belly, and (3) static vibration on MTJ for three-set 60-s vibration in random order. In this study, DF ROM, passive torque, shear elastic modulus, muscle strength, and single-leg drop jump were measured before and immediately after the interventions. The DF ROM and passive torque at DF ROM were increased after all three conditions, whereas the shear elastic modulus was decreased after vibration rolling and static vibration on the muscle belly, but not following static vibration of the MTJ. In addition, there were no significant changes in muscle strength and jump performance in any group. Our results showed that vibration with rolling or static vibration on muscle belly could be effective to improve ROM and muscle stiffness without adverse effects of muscle strength and athletic performance.

Effect of vibration foam rolling on the range of motion in healthy adults: a systematic review and meta-analysis

Professionals use foam rollers to improve range of motion (ROM). Recently, a vibrating foam roller (VFR) that combines the vibration function with a foam roller (FR) has been used. The purpose of this systematic review and meta-analysis was to determine the effects of a VFR on the improvement of ROM in healthy individuals. A systematic literature search was carried out in five international databases: PubMed, Embase, PEDro, Cochrane Library, and Google Scholar. Eight clinical studies, composed of six randomized controlled trials and two randomized crossover trials that involved 230 healthy participants were selected for analysis. Methodological quality was identified using the PEDro scale. The mean scores, 4.75±0.71, of the eight included studies, were classified as fair. The results demonstrated that the VFR achieved better gains than the FR in improving ROM (standardized mean difference [SMD], 0.53; 95% confidence intervals [CIs], 0.29–0.77; I²=55%). The VFR was more effective in improving the ROM than the FR in the hip and knee joints (hip: SMD, 0.56; 95% CI, 0.28–0.85; I²=0%; knee: SMD, 0.86; 95% CI, 0.42–1.30; I²=79%). The VFR may be an additional option to improve the ROM in healthy adults and athletes.

Local vibration therapy increases oxygen re-saturation rate and maintains muscle strength following exercise-induced muscle damage

CONTEXT

Exercise induced muscle damage (EIMD) is associated with transient reductions in strength and athletic performance. Studies conclude aetiology is due in part to muscle micro vascular damage and disruption of blood flow. Previous research on vibration therapy reports modulation in muscle blood flow, oxygenation and strength.

OBJECTIVE

The aim of this study was to observe if local vibration therapy (VT) alleviates the impairments and haemodynamic changes associated with EIMD.

DESIGN

Controlled laboratory study.

SETTING

Laboratory and public gymnasium.

PATIENTS OR OTHER PARTICIPANTS

Ten healthy participants (6 males: 4 females; age: 38±15 yrs; height: 1.72±0.48 m; mass 72.0±10.4 kg) were randomized into experimental (VT) and control (CON) groups.

INTERVENTIONS

Both groups performed 10 sets of 10 eccentric wrist flexions at 70% of 1-repetition maximum to induce muscle damage. Subsequent assessment of wrist flexor strength and flexor carpus ulnaris (FCU) muscle oxygen saturation (SmO2) occurred at 1-, 24- and 48 hr-post exercise. VT group underwent 10 min of local VT (45 Hz) starting 1 hr-post exercise and applied twice daily (separated by 8 hrs) for 48 hrs during habitual waking hours. CON group received no local VT.

MAIN OUTCOME MEASURE(S)

Grip strength, resting muscle oxygen (SmO2), muscle oxygen de-saturation and re-saturation rate.

RESULTS

No difference in grip strength observed pre EIMD, but the VT group demonstrated greater strength at 1 hr (P=0.004), 24 hr (P=0.031) and 48 hr (P=0.021) post EIMD compared to controls. No difference in SmO2 re-saturation over time (P>0.05), but the VT group had a greater re-saturation rate compared to controls at 1 hr (P=0.007, d = 2.6), 24 hr (P=0.001 d = 3.1) and 48 hr (P=0.035, d = 1.7) post EIMD.

CONCLUSIONS

Local VT successfully attenuated the effects of EIMD and increased SmO2 re-saturation in FCU muscles. Including local VT as part of a recovery protocol post-EIMD could be beneficial for rehabilitation and athletic training purposes.

Does a short intervention with vibration foam roller recover lifeguards better after a water rescue? A pilot study

PURPOSE

The aim of this study was to analyze the effects of a recovery program based on foam roller with and without vibration on blood lactate clearance and perceived fatigue after a water rescue.

METHODS

A quasi-experimental crossover design was carried out to compare passive (PR) recovery and a short protocol of foam roller (FR) and vibration foam roller (VFR) recovery after a 100 m water rescue in 7 volunteer lifeguards. Blood lactate and perceived exertion were measured before and after the rescue, and also after the 5-min recovery intervention.

RESULTS

Blood lactate levels decrease significantly with foam roller (p = 0.013; effect size = 0.97) and vibration foam roller recovery (p < 0.001; effect size = 1.62). Passive recovery did not show significant differences clearing out blood lactate. Fatigue perceived decrease significantly with all the recovery methods, but foam roller has higher effects on the global fatigue and VFR on the legs.

CONCLUSION

FR and VFR clear out more blood lactate and decrease fatigue more than PR, with the subsequently increase of the physical conditioning to perform another effort.

Local Vibratory Stimulation for Temporomandibular Disorder Myofascial Pain Treatment: A Randomised, Double-Blind, Placebo-Controlled Preliminary Study

Several methods are currently used to manage pain related to temporomandibular disorder (TMD). Vibratory stimulation is applied as a pain treatment for several musculoskeletal disorders, but it has not yet been studied in-depth for TMD symptoms. The aim of this study is to analyse the effectiveness of at-home local vibration therapy (LVT) for the management of TMDs-related myofascial pain. Methods. Fifty-four TMD patients (43 F, 11 M) with an average age of 40.7 (age range: 29–54 yr.) were randomly subdivided into two groups. The study group (AG) received 1 week of at-home LVT treatment with the NOVAFON Pro Sk2/2 : 50/100 Hz, bilaterally applied to the pain area for 16 minutes daily. The placebo group (IG) followed the same protocol using inactive devices. Temporomandibular joint pain (TMJ), muscular pain (MM), and headache (HA) were assessed. Pain was evaluated using the visual analogue scale (VAS) before (T0) and after therapy (T1). Statistical analysis and Student's t-tests were applied (statistical significance for P < 0.05). Results. AG patients reported decreased average values for all types of pain considered between T0 and T1, with a statistically significant difference for TMJ pain (P < 0.05), MM pain, and HA (P < 0.001). IG patients reported a no statistically significant decrease in the average values of MM pain and an increase in the average values of TMJ pain and HA. Conclusion. The study supports the use of local vibration therapy in the control of TMD-related TMJ pain, local muscular pain, and headache.

Selective Effects of Manual Massage and Foam Rolling on Perceived Recovery and Performance: Current Knowledge and Future Directions Toward Robotic Massages

Manual massage and foam rolling are commonly used by athletes for warm-up and recovery, as well as by healthy individuals for well-being. Manual massage is an ancient practice requiring the intervention of an experienced physiotherapist, while foam rolling is a more recent self-administered technique. These two topics have been largely studied in isolation from each other. In the present review, we first provide a deep quantitative literature analysis to gather the beneficial effects of each technique through an integrative account, as well as their psychometric and neurophysiological evaluations. We then conceptually consider the motor control strategies induced by each type of massage. During manual massage, the person remains passive, lying on the massage table, and receives unanticipated manual pressure by the physiotherapist, hence resulting in a retroactive mode of action control with an ongoing central integration of proprioceptive feedback. In contrast, while performing foam rolling, the person directly exerts pressures through voluntary actions to manipulate the massaging tool, therefore through a predominant proactive mode of action control, where operations of forward and inverse modeling do not require sensory feedback. While these opposite modes of action do not seem to offer any compromise, we then discuss whether technological advances and collaborative robots might reconcile proactive and retroactive modes of action control during a massage, and offer new massage perspectives through a stochastic sensorimotor user experience. This transition faculty, from one mode of control to the other, might definitely represent an innovative conceptual approach in terms of human-machine interactions.

The Recovery Benefit on Skin Blood Flow Using Vibrating Foam Rollers for Postexercise Muscle Fatigue in Runners

PURPOSE

To determine the effect of vibrating rollers on skin blood flow after running for recovery from muscle fatigue.

METHOD

23 healthy runners, aged between 20 to 45 years, participated in a crossover trial. Muscle fatigue was induced by running, and recovery using a vibrating roller was determined before and after the intervention. Each subject was measured at three time points (prerun, postrun, and postroller) to compare skin blood flow perfusion and blood flow oscillation at the midpoint of the dominant gastrocnemius muscle. The results show that blood perfusion is greater when a vibrating roller is used than a foam roller, but there is no statistical difference. The analysis of blood flow oscillation shows that vibrating rollers induce 30% greater endothelial activation than a foam roller. Vibrating rollers significantly stimulate the characteristic frequency for myogenic activation (p < 0.05); however, the effect size is conservative.

INFLUENCE OF AN ACUTE BOUT OF SELF-MYOFASCIAL RELEASE ON KNEE EXTENSION FORCE OUTPUT AND ELECTRO-MECHANICAL ACTIVATION OF THE QUADRICEPS

Background

In contrast to static stretching (SS), previous research has demonstrated increases in flexibility after an acute bout of self-myofascial release (SMR) without any subsequent decreases in force output. Previous research has utilized measures of surface electromyography (sEMG) and mechanomyography (MMG) to examine the influence of SS on the electrical and mechanical processes of muscle activation, respectively. However, there is a lack of research examining the potential changes in electro-mechanical muscle activation post-SMR.

Purpose

To examine the influence of SMR, via an acute bout of foam rolling (FR) to the vastus lateralis (VL), on the expression of knee extension force output and the inter-muscular electro-mechanical activation of the quadriceps musculature.

Study Design

Randomized crossover trial.

Methods

Twenty (10 males, 10 females) recreationally-active participants with prior FR experience completed both SMR and control (CON) testing protocols during separate testing sessions that were conducted in a randomized order 48 hours apart. During the SMR protocol, participants performed 3 sets of 60 seconds of FR over the VL portion of their quadriceps musculature, with 60 seconds of rest between sets. During the CON protocol, participants quietly sat upright for 10 minutes. Peak knee extension force output -(Force_peak) data, as well as sEMG and MMG data from the VL and the rectus femoris (RF) were collected during maximal voluntary isometric contractions (MVICs) before and after both testing protocols. Root mean square sEMG and MMG amplitudes were calculated to represent electro-mechanical muscle activation of the VL (VL-sEMG_RMS, VL-MMG_RMS) and RF (RF-sEMG_RMS, RF-MMG_RMS) musculature.

Results

Repeated measures analyses of variance (RM ANOVAs) identified a significant (p < 0.05) increase in Force_peak within the SMR protocol among males, but no change among females. No statistically significant changes in any electro-mechanical muscle activation measures were identified pre-to-post-SMR within either sex.

Conclusion

In contrast to the SS literature body, these results suggest that SMR does not influence the electro-mechanical aspects of muscle activation during MVICs. These results provide support for the absence of decreases in force output post-SMR, but further examination regarding the potential muscle mass influence of SMR on electro-mechanical muscle function remains warranted.

Level of Evidence

2c.

Roller Massage: Comparing the Immediate Post‐Treatment Effects Between an Instructional Video and a Self‐Preferred Program Using Two Different Density‐Type Roller Balls

The aims of this study were to (1) compare the immediate post-treatment effects of an instructional video versus a self-preferred program on the hip range of motion and a pressure pain threshold using two different density roller balls, and (2) compare the effects of the two roller balls on those variables. Forty adults were randomly allocated into four groups: (1) MB1-video, (2) MB1-self-preferred, (3) MBX-video, and (4) MBX-self-preferred. Participants followed a video or a self-preferred program using either a moderate (MB1) or a hard (MBX) density ball. Main outcomes were passive hip internal rotation, external rotation, and a pressure pain threshold. For MB1, the video produced greater outcomes than the self-program for external rotation (10◦ versus 2◦), internal rotation (7◦ versus 2◦), and the pain threshold (210 kPa versus 44 kPa). For MBX, the video produced greater outcomes than the self-program for external rotation (8◦ versus 1◦), internal rotation (5◦ versus 1◦), and the pain threshold (184 kPa versus 30 kPa). When comparing roller balls, the MB1 produced greater outcomes than the MBX for external rotation (10◦ versus 8◦), internal rotation (7◦ versus 5◦), and the pain threshold (210 kPa versus 184 kPa) with the video. For the self-preferred program, the MB1 produced greater outcomes for external rotation (2◦ versus 1◦), internal rotation (2◦ versus 1◦), and the pain threshold (44 kPa versus 30 kPa). The instructional video and a moderate density ball produced greater immediate post-treatment outcomes than the self-program and a hard density ball. Professionals should consider using the video to teach technique and match clients to a specific density-type roller ball.

Effects of Vibration Rolling with and without Dynamic Muscle Contraction on Ankle Range of Motion, Proprioception, Muscle Strength and Agility in Young Adults: A Crossover Study

Vibration rolling (VR) has emerged as a self-myofascial release (SMR) tool to aid exercise performance when warming up. However, the benefits of VR on exercise performance when combined with dynamic muscle contraction are unclear. The purpose of this study was to investigate the immediate effects of the combination of VR with dynamic muscle contraction (DVR), VR, and static stretching (SS) during warm-up on range of motion (ROM), proprioception, muscle strength of the ankle, and agility in young adults. In this crossover design study, 20 recreationally active adults without musculoskeletal disorders completed three test sessions in a randomized order, with 48 h of rest between each session. Participants completed one warm-up intervention and its measurements on the same day; different warm-up interventions and measurements were performed on each of the three days. The measurements included ankle dorsiflexion and plantarflexion ROM, ankle joint proprioception, muscle strength, and agility. After DVR and VR intervention, ankle dorsiflexion ROM (both DVR and VR, p < 0.001), plantarflexion ROM (both DVR and VR, p < 0.001), plantar flexor muscle strength (DVR, p = 0.007; VR, p < 0.001), and agility (DVR, p = 0.016; VR, p = 0.007) significantly improved; after SS intervention, ankle dorsiflexion and plantar flexion ROM (dorsiflexion, p < 0.001; plantar flexion, p = 0.009) significantly improved, but muscle strength and agility were not enhanced. Compared with SS, DVR and VR significantly improved ankle plantar flexor muscle strength (p = 0.008 and p = 0.001, respectively). Furthermore, DVR significantly improved ankle dorsiflexion compared with VR (p < 0.001) and SS (p < 0.001). In conclusion, either DVR, VR, or SS increased ankle ROM, but only DVR and VR increased muscle strength and agility. In addition, DVR produced considerable increases in ankle dorsiflexion. These findings may have implications for warm-up prescription and implementation in both rehabilitative and athletic practice settings.

Effect of vibration vs non-vibration foam rolling techniques on flexibility, dynamic balance and perceived joint stability after fatigue

Background

Foam roller and vibration techniques are currently used to assist in recovery after fatigue. The main purpose of this study was to determine the effects of the use of a foam roller with and without vibration on dynamic balance, ankle dorsiflexion, hamstring and lumbar spine flexibility and perceived knee and ankle stability after an induced fatigue protocol.

Methods

A total of 24 healthy recreationally active participants (17 males and seven females) were recruited to a randomized cross over trial consisting of; no treatment (NT), foam roller treatment (FR) and vibration foam roller treatment (VFR). The assessments included; the Sit & Reach test, Y balance test and post-treatment perceived knee and ankle stability. Measurements were taken after a standardized warm up (baseline) and repeated following an exercise-induced muscle fatigue protocol consisting of repeated lunges until volitional fatigue. The three treatment conditions were assessed on three separate days in a randomized order. A 3 × 3 repeated measures ANOVA was used to investigate differences between the three treatments over the three time points and a one factor repeated measures ANOVA was used to determine any differences between treatments using the Global Rate of Change scale when considering perceived stability.

Results

FR and VFR conditions both showed a greater ankle dorsiflexion range of motion (ROM) (p < 0.001), greater posteromedial and posterolateral reach distances (p < 0.001) and a better knee and ankle perceived stability (p < 0.001) when compared to the NT condition. A trend toward significance was observed in the hamstring and lumbar spine flexibility (p = 0.074) in both treatment conditions when compared to the NT condition. However, no differences were seen between the FR and VFR conditions.

Conclusions

Both FR conditions seem to assist in exercise-induced muscle fatigue recovery with improvements in ROM, balance and perceived stability.

The effects of vibration foam roller applied to hamstring on the quadriceps electromyography activity and hamstring flexibility

This study investigates the effect of vibration foam roller (VFR) applied to the hamstring, on the quadriceps electromyography (EMG) activity and hamstring flexibility. A total of 16 subjects were randomly assigned to either the VFR group (n=8) or the nonvibration foam roller group (NVFR, n=8). The two groups applied the foam roller or the VFR to the dominant hamstring, at a rate of 40 times per min, for a total of 200 times in 5 min. The primary outcome was to measure hamstring extensibility using the sit and reach test. The EMG activity of the dominant rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) was measured as the secondary outcome. Results indicate a significant increase in the sit and reach distance after the intervention in both groups, as compared to preintervention. The sit and reach difference between VFR and NVFR show no significant difference after the intervention. Significant increases were observed after intervention in the %maximum voluntary isometric contraction (%MVIC) of VL, VM, and RF in the VFR group, and RF in the NVFR group, as compared to the preintervention values. Furthermore, %MVIC values of VL and RF, but not the VM muscle, were significantly different between the two groups. These findings suggest that regardless of vibration, the application of foam roller to hamstring may exert a positive effect on hamstring flexibility. Furthermore, these results indicate that the application of foam roller with vibrations causes more EMG activation in the antagonists.

Unilateral hamstring foam rolling does not impair strength but the rate of force development of the contralateral muscle

BACKGROUND

Self-administered foam rolling (SAFR) is an effective massage technique often used in sport and rehabilitation settings to improve range of motion (ROM) without impairing the strength performance. However, the effects of unilateral SAFR on contralateral non-intervened muscle's rate of force development (RFD) are unknown. Therefore, the purpose of this investigation was to examine the acute effects of unilateral hamstrings SAFR on the contralateral limb flexibility, the isometric strength, and the RFD parameters.

METHODS

Thirty-four subjects (21 women) completed two separate randomly sequenced experimental visits, during which the control (rested for 10 min) or ten, 30-second SAFR were performed with the dominant hamstring muscle group. Before (Pre) and after (Post) the interventions, the contralateral hip flexion passive ROM, the maximal explosive isometric strength of the contralateral knee flexors with the corresponding prime mover muscles' surface electromyographic (EMG) amplitude were measured. Separate two-way (time ×intervention) repeated measures analyses of variance (ANOVAs) were used to examine the potential changes of the dependent variables.

RESULTS

The SAFR significantly improved the contralateral limb ROM (Pre vs. Post: 68.3 ± 21.0 vs. 73.2 ± 23.2 degrees, p < 0.001; d = 0.22). No change was found for the contralateral isometric strength or the maximal EMG amplitude. For the RFD parameters, the percent changes of the RFDs for the first 50, 100, and 200 ms of the maximal explosive isometric contraction were -31.2%, -16.8%, and -10.1%, respectively, following the unilateral SAFR, relative to the control condition. In addition, the decrement of the first 50-ms RFD reached statistical significance (p = 0.007; Cohen's d = 0.44).

CONCLUSION

Ten sets of 30-second unilateral hamstring SAFR improved the ROM of the non-intervened contralateral limb, but decreased its ability to generate force, especially during the early phase (e.g., 50 ms) of the maximal explosive contraction.

A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery

Foam rolling is thought to improve muscular performance and flexibility as well as to alleviate muscle fatigue and soreness. For this reason, foam rolling has become a popular intervention in all kinds of sport settings used to increase the efficiency of training or competition preparation as well as to speed post-exercise recovery. The objective of this meta-analysis was to compare the effects of foam rolling applied before (pre-rolling as a warm-up activity) and after (post-rolling as a recovery strategy) exercise on sprint, jump, and strength performance as well as on flexibility and muscle pain outcomes and to identify whether self-massage with a foam roller or a roller massager is more effective. A comprehensive and structured literature search was performed using the PubMed, Google Scholar, PEDro, and Cochrane Library search engines. Twenty-one studies were located that met the inclusion criteria. Fourteen studies used pre-rolling, while seven studies used post-rolling. Pre-rolling resulted in a small improvement in sprint performance (+0.7%, g = 0.28) and flexibility (+4.0%, g = 0.34), whereas the effect on jump (-1.9%, g = 0.09) and strength performance (+1.8%, g = 0.12) was negligible. Post-rolling slightly attenuated exercise-induced decreases in sprint (+3.1%, g = 0.34) and strength performance (+3.9 %, g = 0.21). It also reduced muscle pain perception (+6.0%, g = 0.47), whereas its effect on jump performance (-0.2%, g = 0.06) was trivial. Of the twenty-one studies, fourteen used foam rollers, while the other seven used roller massage bars/sticks. A tendency was found for foam rollers to offer larger effects on the recovery of strength performance (+5.6%, g = 0.27 vs. -0.1%, g = -0.01) than roller massagers. The differences in the effects between foam rolling devices in terms of pre-rolling did not seem to be of practical relevance (overall performance: +2.7 %, g = 0.11 vs. +0.4%, g = 0.21; flexibility: +5.0%, g = 0.32 vs. +1.6%, g = 0.39). Overall, it was determined that the effects of foam rolling on performance and recovery are rather minor and partly negligible, but can be relevant in some cases (e.g., to increase sprint performance and flexibility or to reduce muscle pain sensation). Evidence seems to justify the widespread use of foam rolling as a warm-up activity rather than a recovery tool.

The immediate effects of foam roller with vibration on hamstring flexibility and jump performance in healthy adults

This study aimed to determine whether foam roller with vibration (FRV) can improve hamstring flexibility and jump performance in young adults. Twenty subjects were randomly allocated into either the FRV or the foam-roller with no vibration (FRNV) groups. The vibration of the vibration foam-roller was 32 Hz. All participants completed one 10-min session on the hamstring. Active straight leg raising (ASLR) test in supine position and active knee extension (AKE) test in sitting position were performed to measure hamstring flexibility, before and immediately after the session. ASLR, AKE, and vertical jump performance test were performed before the session and immediately after the session. Analysis of covariance was used to determine statistical significance. ASLR and AKE tests were significantly different between FRV and FRNV, except the right hamstring. There was significant improvement with respect to ASLR and AKE tests after the session in FRV group. The vertical jump performance test of both groups was not significantly different after the session. FRV is more effective than FRNV for improving hamstring flexibility.

The Parameters of Foam Rolling, Self-Myofascial Release Treatment: A Review of the Literature

Self-myofascial release (SMR) is a well-known and popular therapy. Its growing popularity is based on high effectiveness and availability. However, there is a lack of agreement about which parameters should be used to optimize the effects of the therapy. The purpose of this review is to critically select and assess current literature and ascertain the values of the follow­ing parameters: (1) therapy duration, (2) volume of applied pressure, (3) speed and (4) frequency of roll, (5) type of roller, (6) the number of treatment applications during one session, (7) the duration of intervals between applications that yield the best results in terms of soft tissue.

The authors launched their research in May 2018. The search strategy included the electronic databases EBSCOhost and PubMed. The following inclusion criteria were assessed:

- English language, high quality manuscripts (evaluation in PEDro scale)

- at least one of the groups using the foam roller, tennis ball or the stick to fascial release

- basic parameters of therapy described.A total 55 articles met the inclusion criteria. Patients can usually withstand a maximum tolerable pressure for 30-120 seconds, repeated 1-3 times, separated by 30 seconds of rest. The intensity of a single rolling movement should be moderate, and the movement should last about 3 seconds. Keeping the roller on particularly sensitive areas is recommended to release tension and enhance blood perfusion.Currently, there is no consensus on an optimal FR programme. However, there is a tendency to use SMR tools with a physiol­ogy-based method to enhance therapeutic efficiency.

Comparison of vibration rolling, nonvibration rolling, and static stretching as a warm-up exercise on flexibility, joint proprioception, muscle strength, and balance in young adults

Warm-up is an essential component for optimizing performance before an exercise session. This study investigated that the immediate effects of vibration rolling (VR), nonvibration rolling (NVR), and static stretching as a part of a warm-up regimen on the flexibility, knee joint proprioception, muscle strength, and dynamic balance of the lower extremity in young adults. Compared with the preintervention, VR induced the range of motion of knee flexion and extension significantly increased by 2.5% and 6%, respectively, and isokinetic peak torque and dynamic balance for muscle strength and dynamic balance increased by 33%-35% and 1.5%, respectively. In the three conditions, most outcomes between VR and NVR were comparable; however, the participants had a significantly higher knee joint reposition error after NVR than after VR, indicating that NVR would have a hampering knee joint proprioception effect. In particular, compared with static stretching, VR significantly increased the quadriceps muscle strength by 2-fold and dynamic balance by 1.8-fold. These findings suggest that athletic professionals may take VR into account for designing more efficient and effective preperformance routine to improve exercise performances. VR has high potential to translate into an on-field practical application.