Acute effects of cold, heat and contrast pressure therapy on forearm muscles regeneration in combat sports athletes: a randomized clinical trial

Due to the specific loads that occur in combat sports athletes' forearm muscles, we decided to compare the immediate effect of monotherapy with the use of compressive heat (HT), cold (CT), and alternating therapy (HCT) in terms of eliminating muscle tension, improving muscle elasticity and tissue perfusion and forearm muscle strength. This is a single-blind, randomized, experimental clinical trial. Group allocation was performed using simple 1:1 sequence randomization using the website randomizer.org. The study involved 40 40 combat sports athletes divided into four groups and four therapeutic sessions lasting 20 min. (1) Heat compression therapy session (HT, n = 10) (2) (CT, n = 10), (3) alternating (HCT, n = 10), and sham, control (ShT, n = 10). All participants had measurements of tissue perfusion (PU, [non-reference units]), muscle tension (T-[Hz]), elasticity (E-[arb- relative arbitrary unit]), and maximum isometric force (Fmax [kgf]) of the dominant hand at rest (Rest) after the muscle fatigue protocol (PostFat.5 min), after therapy (PostTh.5 min) and 24 h after therapy (PostTh.24 h). A two-way ANOVA with repeated measures: Group (ColdT, HeatT, ContrstT, ControlT) × Time (Rest, PostFat.5 min, PostTh.5 min, Post.24 h) was used to examine the changes in examined variables. Post-hoc tests with Bonferroni correction and ± 95% confidence intervals (CI) for absolute differences (△) were used to analyze the pairwise comparisons when a significant main effect or interaction was found. The ANOVA for PU, T, E, and Fmax revealed statistically significant interactions of Group by Time factors (p < 0.0001), as well as main effects for the Group factors (p < 0.0001; except for Fmax). In the PostTh.5 min. Period, significantly (p < 0.001) higher PU values were recorded in the HT (19.45 ± 0.91) and HCT (18.71 ± 0.67) groups compared to the ShT (9.79 ± 0.35) group (△ = 9.66 [8.75; 10.57 CI] > MDC(0.73), and △ = 8.92 [8.01; 9.83 CI] > MDC(0.73), respectively). Also, significantly (p < 0.001) lower values were recorded in the CT (3.69 ± 0.93) compared to the ShT (9.79 ± 0.35) group △ = 6.1 [5.19; 7.01 CI] > MDC(0.73). For muscle tone in the PostTh.5 m period significantly (p < 0.001) higher values were observed in the CT (20.08 ± 0.19 Hz) group compared to the HT (18.61 ± 0.21 Hz), HCT (18.95 ± 0.41 Hz) and ShT (19.28 ± 0.33 Hz) groups (respectively: △ = 1.47 [1.11; 1.83 CI] > MDC(0.845); △ = 1.13 [0.77; 1.49 CI] > MDC(0.845), and △ = 0.8 [0.44; 1.16 CI], < MDC(0.845)). The highest elasticity value in the PostTh.5 m period were observed in the CT (1.14 ± 0.07) group, and it was significantly higher than the values observed in the HT (0.97 ± 0.03, △ = 0.18 [0.11; 0.24 CI] > MDC(0.094), p < 0.001), HCT (0.90 ± 0.04, △ = 0.24 [0.17; 0.31 CI] > MDC(0.094), p < 0.001) and ShT (1.05 ± 0.07, △ = 0.094 [0.03; 0.16 CI] = MDC(0.094), p = 0.003) groups. For Fmax, there were no statistically significant differences between groups at any level of measurement. The results of the influence of the forearm of all three therapy forms on the muscles' biomechanical parameters confirmed their effectiveness. However, the effect size of alternating contrast therapy cannot be confirmed, especially in the PostTh24h period. Statistically significant changes were observed in favor of this therapy in PU and E measurements immediately after therapy (PostTh.5 min). Further research on contrast therapy is necessary.

The Effect of Combined Transcranial Direct Current Stimulation and Pneumatic Compression as Part of a Comprehensive Recovery Strategy in Professional Male Top-Level Soccer Players

ABSTRACT

Gonçalves, DS, Moscaleski, LA, da Silva, GM, Morgans, R, Okano, AH, and Moreira, A. The effect of combined transcranial direct current stimulation and pneumatic compression as part of a comprehensive recovery strategy in professional male top-level soccer players. J Strength Cond Res 38(9): 1658-1666, 2024-This retrospective study aimed to examine the effect of transcranial direct current stimulation (tDCS) combined with lower limb pneumatic compression during the postmatch recovery period in top-level professional male soccer players' physiological and perceptual markers of recovery status. During the 2022 season (baseline), pneumatic compression was performed as part of the recovery strategy, applied the day after official match play and psychophysiological measurements (pain, sleep, perceived recovery, and creatine kinase [CK] sampling) were performed on the second day postmatch. During the 2023 season, the tDCS protocol was introduced, with its application being performed simultaneously (in conjunction) with pneumatic compression. Recovery sessions following 10 matches in the 2022 season and following 10 matches in the 2023 season were included in the analyses. Compared with 2022 (baseline; pneumatic compression isolated), the players perceived an increased recovery on the second day postmatch when tDCS was used in conjunction with the pneumatic compression (mean = 12%; p = 0.008) and rated improved sleep quality for the nights after applying tDCS combined with pneumatic compression (mean = 7.5%; p = 0.029). On the second day postmatch, a significant reduction was observed in muscle pain/soreness (mean = 64%; p < 0.0001) and the CK concentration decreased when baseline (pneumatic compression isolated) was compared with tDCS + pneumatic compression (mean = 76%; p = 0.001). In summary, combining pneumatic compression with tDCS may enhance the effects of both interventions, leading to greater overall improvements in recovery. Further research is warranted to confirm these findings and explore the underlying mechanisms in more detail.

Effects of intermittent pneumatic compression on the recovery of cardiovascular parameters after repeated sprint exercise

PURPOSE

Intermittent pneumatic compression (IPC) applies gradual pressure to facilitate lymph and blood flow movement to reduce exercise-induced tissue fluid accumulation and plasma volume loss. This study aimed to evaluate the cardiovascular system response during the recovery with IPC compared with passive recovery (Sham).

METHODS

Sixteen volunteers (7 females and 9 males) executed a cycling-based exhausting sprint interval exercise (8 × 20 s all out), followed by a 30-min IPC or Sham condition. Participants performed two trials in a randomised, counterbalanced, and crossover design. Several cardiovascular parameters (blood pressure, heart function, and peripheral vascular resistance) were recorded at baseline (5'), through the recovery protocol (30'), and afterwards (5').

RESULTS

The use of IPC during the recovery phase led to a faster recovery, stated in relative values to pre-exercise, in mean blood pressure (102.5 ± 19.3% vs. 92.7 ± 12.5%; P < 0.001), and cardiac output (139.8 ± 30.0% vs. 146.2 ± 40.2%; P < 0.05) in comparison to Sham condition. Furthermore, during the IPC-based recovery, there was a slower recovery in cardiac pressure change over time (92.5 ± 25.8% vs. 100.5 ± 48.9%; P < 0.05), and a faster return to pre-exercise values in the peripheral vascular resistance (75.2 ± 25.5% vs. 64.8 ± 17.4%; P < 0.001) compared to Sham.

CONCLUSION

The application of IPC after high-intensity exercise promotes the recovery of the cardiovascular system, reducing cardiovascular strain. Future investigations should consider the effects on the sympathetic-parasympathetic balance, such as heart rate variability, to assess further bonds between the use of IPC and autonomous control.

Effects of different intermittent pneumatic compression stimuli on ankle dorsiflexion range of motion

Despite substantial evidence of the effectiveness of intermittent pneumatic compression (IPC) treatments for range of motion (ROM) improvement, little evidence is available regarding how different IPC stimuli affect ankle dorsiflexion (DF) ROM. This study aimed to investigate the effects of different IPC stimuli on the ankle DF ROM. Fourteen, university intermittent team sport male athletes (age: 21 ± 1 year, height: 1.74 ± 0.05 m, body mass: 70.9 ± 7.7 kg, body fat percentage: 14.2 ± 3.6%, body mass index: 23.5 ± 2.5 kg/m²; mean ± standard deviation) completed four experimental trials in a random order: 1) no compression with wearing IPC devices (SHAM), 2) the sequential compression at approximately 80 mmHg (SQUEE80), 3) the uniform compression at approximately 80 mmHg (BOOST80), and 4) the uniform compression at approximately 135 mmHg (BOOST135). For the experimental trials, the participants were initially at rest for 10 min and then assigned to either a 30-min SHAM, SQUEE80, BOOST80, or BOOST135. Participants rested for 20 min after IPC treatment. The Weight-Bearing Lunge Test (WBLT), popliteal artery blood flow, pressure-to-pain threshold (PPT), muscle hardness, heart rate variability, and perceived relaxation were measured before (Pre) and immediately after IPC treatment (Post-0) and 20 min after IPC treatment (Post-20), and the changes in all variables from Pre (Δ) were calculated. ΔWBLT performance, ΔPPT, and Δperceived relaxation in all IPC treatments were significantly higher than those in SHAM at Post-0 and Post-20 (p < 0.05). ΔPopliteal artery blood flow in BOOST80 and BOOST135 was significantly higher than that in SHAM and SQUEE80 at Post-0 (p < 0.05). ΔMuscle hardness and Δheart rate variability did not differ significantly between trials. In conclusion, IPC treatments, irrespective of applied pressure and mode of compression, increased ankle DF ROM. This resulted from decreased pain sensitivity (i.e., increased PPT). In addition, high inflation pressure and frequency did not provide additional benefits in increasing ankle DF ROM.

Effects of an external pneumatic compression device vs static compression garment on peripheral circulation and markers of sports performance and recovery

PURPOSE

To identify the effects of a single 30 min partial lower leg external pneumatic compression (EPC) treatment compared to a static compression (SC) garment or a no treatment control (CTL) on markers of recovery and performance following a muscle damaging protocol.

METHODS

Thirty healthy, active males (23 ± 3 years; 180.2 ± 9.0 cm; 81.6 ± 11.3 kg) performed 100 drop jumps from a 0.6 m box followed by a randomized, single 30 min treatment of either a partial lower leg EPC device worn below the knee and above the ankle (110 mmHg), SC garment (20-30 mmHg) covering the foot and calf just below the knee, or no treatment CTL, and then returned 24 and 48 h later. Participants were assessed for measures of muscle soreness, fatigue, hemodynamics, blood lactate, muscle thickness, circumferences, and performance assessments.

RESULTS

The drop jump protocol significantly increased muscle soreness (p < 0.001), fatigue (p < 0.001), blood flow (p < 0.001), hemoglobin (p < 0.001), and muscle oxygen saturation (SMO₂; p < 0.001). Countermovement jump and squat jump testing completed after treatment with either EPC, SC, or CTL revealed no differences for jump height between any condition. However, EPC treatment maintained consistent braking force and propulsive power measures across all timepoints for countermovement jump testing. EPC and SC treatment also led to better maintenance of squat jump performance for average relative propulsive force and power variables at 24 and 48 h compared to CTL.

CONCLUSIONS

A single 30 min partial leg EPC treatment may lead to more consistent jump performance following a damaging bout of exercise.

The Effect of Pressotherapy on Performance and Recovery in the Management of Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis

Background: It has been demonstrated that pressotherapy used post-exercise (Po-E) can influence training performance, recovery, and physiological properties. This study examined the effectiveness of pressotherapy on the following parameters. Methods: The systematic review and meta-analysis were performed according to PRISMA guidelines. A literature search of MEDLINE, PubMed, EBSCO, Web of Science, SPORTDiscus, and ClinicalTrials has been completed up to March 2021. Inclusion criteria were: randomized control trials (RCTs) or cross-over studies, mean participant age between 18 and 65 years, ≥1 exercise mechanical pressotherapy intervention. The risk of bias was assessed by the Cochrane risk-of-bias tool for RCT (RoB 2.0). Results: 12 studies comprised of 322 participants were selected. The mean sample size was n = 25. Pressotherapy significantly reduced muscle soreness (Standard Mean Difference; SMD = −0.33; CI = −0.49, −0.18; p < 0.0001; I2 = 7%). Pressotherapy did not significantly affect jump height (SMD = −0.04; CI = −0.36, −0.29; p = 0.82). Pressotherapy did not significantly affect creatine kinase level 24−96 h after DOMS induction (SMD = 0.41; CI = −0.07, 0.89; p = 0.09; I2 = 63%). Conclusions: Only moderate benefits of using pressotherapy as a recovery intervention were observed (mostly for reduced muscle soreness), although, pressotherapy did not significantly influence exercise performance. Results differed between the type of exercise, study population, and applied treatment protocol. Pressotherapy should only be incorporated as an additional component of a more comprehensive recovery strategy. Study PROSPERO registration number—CRD42020189382.

"Everything Old Is New Again": A Review of Current Complementary and Alternative Medicine Trends

Complementary and alternative medicine therapies can be used as adjuvant or preventive therapy, and have newer applications: cryotherapy, halotherapy, floatation therapy, and compression therapy. Nurse practitioners need to know about these therapies and their applicability to patient populations. Appropriate integration of these therapies is part of holistic care, which they strive to provide.

Neither Peristaltic Pulse Dynamic Compressions nor Heat Therapy Accelerate Glycogen Resynthesis after Intermittent Running

PURPOSE

To investigate the effects of a single session of either peristaltic pulse dynamic leg compressions (PPDC) or local heat therapy (HT) after prolonged intermittent shuttle running on skeletal muscle glycogen content, muscle function, and the expression of factors involved in skeletal muscle remodeling.

METHODS

Twenty-six trained individuals were randomly allocated to either a PPDC (n = 13) or a HT (n = 13) group. After completing a 90-min session of intermittent shuttle running, participants consumed 0.3 g·kg-1 protein plus 1.0 g·kg-1 carbohydrate and received either PPDC or HT for 60 min in one randomly selected leg, while the opposite leg served as control. Muscle biopsies from both legs were obtained before and after exposure to the treatments. Muscle function and soreness were also evaluated before, immediately after, and 24 h after the exercise bout.

RESULTS

The changes in glycogen content were similar (P > 0.05) between the thigh exposed to PPDC and the control thigh ~90 min (Control: 14.9 ± 34.3 vs PPDC: 29.6 ± 34 mmol·kg-1 wet wt) and ~210 min (Control: 45.8 ± 40.7 vs PPDC: 52 ± 25.3 mmol·kg-1 wet wt) after the treatment. There were also no differences in the change in glycogen content between thighs ~90 min (Control: 35.9 ± 26.1 vs HT: 38.7 ± 21.3 mmol·kg-1 wet wt) and ~210 min (Control: 61.4 ± 50.6 vs HT: 63.4 ± 17.5 mmol·kg-1 wet wt) after local HT. The changes in peak torque and fatigue resistance of the knee extensors, muscle soreness, and the mRNA expression and protein abundance of select factors were also similar (P > 0.05) in both thighs, irrespective of the treatment.

CONCLUSIONS

A single 1-h session of either PPDC or local HT does not accelerate glycogen resynthesis and the recovery of muscle function after prolonged intermittent shuttle running.

The Use of Upper-Body Intermittent Sequential Pneumatic Compression Arm Sleeves on Recovery From Exercise in Wheelchair Athletes

OBJECTIVE

The aim of the current study was to investigate the efficacy of an upper-body intermittent sequential pneumatic compression device on recovery after wheelchair team sport activity.

DESIGN

Eleven well-trained wheelchair basketball and rugby athletes (male, 8; female, 3; mean ± SD age = 33 ± 10 yrs) performed a series of performance measures pre-exercise, postexercise, and postrecovery (grip strength, pressure-to-pain threshold, medicine ball throw, wheelchair sprints, repeated sprints). Subjective muscle soreness and fatigue measurements were taken at the same time points as performance tests, with an additional 24-hr postrecovery measure. Participants completed two recovery trials, separated by 1 wk, of either passive recovery (control) or 20 mins of wearing recovery arm sleeves (intermittent sequential pneumatic compression) applied to both arms.

RESULTS

No statistically significant differences were found between trials for any of the performance or perceptual measures (P > 0.05). However, effect size analysis revealed a moderate decrease (d = -0.67) from postexercise to postrecovery for muscle fatigue in favor of intermittent sequential pneumatic compression. A large decrease (d = -0.96) in muscle soreness was also found after exercise to 24 hrs after recovery in favor of intermittent sequential pneumatic compression over control.

CONCLUSIONS

Intermittent sequential pneumatic compression may provide some benefit for perceptual recovery measures immediately after and 24 hrs after a high-intensity wheelchair activity with negligible effects on performance recovery.

Effects of the infrared laser on classical ballerinas' feet: Analysis of plantar foot and static balance

BACKGROUND AND PURPOSE

Overuse injuries and painful symptoms in athletes and dancers (especially classical ballerinas) may lead to reduced functional performance. However, laser application may reduce pain and increase physical conditioning. The aim of the current study was to evaluate the immediate and long-term effects of infrared laser on classical ballerinas' feet.

METHODS

Eight female adults who perform classical ballet training and feel pain in their foot, but report no injuries in the last 6 months participated in the study. Infrared laser (808 nm) was applied on ballerina's feet twice a week during three months. The laser parameters utilized were 100 mW average optical power and spot size of 0.04 cm² applied during 1 min, leading to 6 J and 125 J/cm² per point. Thermography, algometry and unipodal static standing balance test were performed.

RESULTS

There was a significant increase in plantar arch temperature (1.6 °C for center and 2.3 °C for border, p < 0.05) immediately after laser treatment for all ballerinas. The pressure pain thresholds (PPT) were significantly increased for 5 of 7 analyzed sites (p < 0.05). Regarding to the static standing balance, the time on one-foot showed a significant increases (from 23 ± 12 s to 34 ± 13 s, p < 0.05) only when the test was performed on the left foot (support foot).

CONCLUSION

Then, there were pain relief and improvement of functional performance in ballerinas. The possible mechanism of laser action in reducing pain and thus enhancing performance, like higher blood flow of foot due to an increase of cutaneous temperature, will be discussed.

Hyperelastic Properties of Platinum Cured Silicones and its Applications in Active Compression

This paper presents the fundamental research of design, development, and evaluation of an active compression system consisting of silicone based inflatable mini-bladders, which could be used in applying radial pressure for the treatment of venous disease. The use of mini-bladders will nullify the effect of radius of curvature and provide a higher resolution to the pressure distribution. They are designed with two elastomeric layers and inflation is limited only to one side. The mini-bladders apply a radial force onto the treated surface when inflated, and the pressure inside mini-bladders could be measured using the concept of back pressure, which provides the flexibility to inflate mini-bladders to a predefined pressure. The 3-D deformation profile of the mini-bladders was analysed using finite element method (FEM) and FEM simulations were validated with experimental data, which showed good agreement within pressure region required for the treatment of venous disease. Finally, the pressure transmission characteristics of mini-bladders were evaluated on a biofidellic lower leg surrogate and the results have shown that the mini-bladders could apply a uniform pressure irrespective of the location on the leg with a 60%–70% of inlet pressure successfully transmitted onto the leg surface, while 40%–50% was available after the fat layers.

Sequential Pulse Compression's Effect on Blood Flow in the Lower-Extremity

CONTEXT

Several interventions are available to reduce the intensity and duration of the unwanted effects (eg, muscle soreness) associated with physical activity, such as massage, compression garments, and sequential pulse compression (SPC). Such interventions aim to increase blood flow to alleviate symptoms. However, there is a lack of evidence to support the use of SPC to alter total hemoglobin concentration (THb) in active individuals.

OBJECTIVE

To examine the acute effects of a single session of SPC on hemoglobin concentration compared with a control condition.

DESIGN

Single cohort, crossover design.

PARTICIPANTS

Thirty-four physically active and healthy participants (females = 12 and males = 22) completed the study.

INTERVENTIONS

The authors randomly assigned participants to first receive the experimental (SPC) or control condition. Measures were recorded precondition and postcondition. Participants returned to the laboratory to complete the second condition ≥24 hours after the first condition.

MAIN OUTCOME MEASURES

Relative changes in THb, deoxygenated hemoglobin, and oxygenated hemoglobin measures were recorded using near-infrared spectroscopy placed on the muscle belly of the medial gastrocnemius of the dominant limb.

RESULTS

SPC significantly increased THb (P < .001, d = 0.505) and oxygenated hemoglobin (P < .001, d = 0.745) change scores compared with the control condition. No statistical difference in deoxygenated hemoglobin change scores was found between the SPC and control conditions, but a medium effect size suggests potential biological significance (P = .06, d = 0.339).

CONCLUSIONS

Overall, SPC increases THb to the lower-extremity and may be a viable option in the management of muscle soreness related to physical activity.

Effects of External Counterpulsation on Postexercise Recovery in Elite Rugby League Players

PURPOSE

External counterpulsation (ECP) has previously been used to treat cardiac patients via compression of the lower extremities during diastole to increase venous return and coronary perfusion. However, the effects of ECP on exercise performance and markers of recovery in elite athletes are largely unknown.

METHODS

On 2 separate occasions, 48 h apart, 7 elite National Rugby League players performed an identical 60-min field-based conditioning session followed by a 30-min period of either regular ECP treatment or placebo. Power measures during repeated cycle bouts and countermovement jump height and contraction time derivatives were measured at rest and 5 h postexercise. Saliva samples and venous blood samples were taken at rest, postexercise, and 5 h postexercise to assess stress, inflammation, and muscle damage.

RESULTS

After ECP treatment, cycling peak power output (P = .028; 11%) and accumulated peak power (P = .027; 14%) increased compared with the placebo condition. Postexercise plasma interleukin 1 receptor antagonist only increased after ECP (P = .024; 84%), and concentrations of plasma interleukin 1 receptor antagonist tended to be higher (P = .093; 76%) 5 h postexercise. Furthermore, testosterone-to-cortisol ratio was increased above baseline and placebo 5 h postexercise (P = .017-.029; 24-77%). The ratio of postexercise salivary α-amylase to immunoglobulin A decreased after treatment (P = .013; 50%) compared with the placebo control.

CONCLUSIONS

Exercise performance and hormonal indicators of stress were improved and inflammation markers were reduced following acute ECP.

Lymphatic Function in Autoimmune Diseases

Lymphatic vessels are critical for clearing fluid and inflammatory cells from inflamed tissues and also have roles in immune tolerance. Given the functional association of the lymphatics with the immune system, lymphatic dysfunction may contribute to the pathophysiology of rheumatic autoimmune diseases. Here we review the current understanding of the role of lymphatics in the autoimmune diseases rheumatoid arthritis, scleroderma, lupus, and dermatomyositis and consider the possibility that manual therapies such as massage and acupuncture may be useful in improving lymphatic function in autoimmune diseases.

Considerations in the Diagnosis and Accelerated Return to Sport of a Professional Basketball Player With a Triceps Surae Injury: A Case Report

Study Design Case report. Background Acute injuries of the triceps surae and Achilles tendon are common in sports. Rupture of the plantaris tendon can be challenging to diagnose. There is limited evidence detailing the diagnosis, rehabilitation, and accelerated return to sport of elite professional basketball players who have sustained calf injuries. Case Description A 25-year-old male professional basketball player sustained an injury to his calf during a professional basketball game. This case report details the presumptive diagnosis, graduated progression of intervention, and return to play of a professional athlete with a likely isolated plantaris tendon tear. Outcomes The patient returned to postseason competition 10 days post injury. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Before returning to play, the athlete showed improvements beyond the minimal clinically important difference for calf girth (2 cm) and numeric pain-rating scale score (4 points, 0-10 scale). Functional testing was conducted that included the Y Balance Test lower quarter and the Functional Movement Screen, with results that exceeded or returned the athlete to preseason levels. Discussion This report details the case of a professional basketball player who returned to competitive play in an accelerated time frame following injury to his calf. Diagnosing a plantaris tendon rupture can be challenging, and anatomical variations of this muscle should be considered. It was demonstrated in this case that physical therapy rehabilitation was helpful in making a treatment-based clinical diagnosis when imaging was unclear. Level of Evidence Therapy, level 5. J Orthop Sports Phys Ther 2018;48(5):388-397. Epub 6 Apr 2018. doi:10.2519/jospt.2018.7192.

A randomized controlled trial of manual therapy and pneumatic compression for recovery from prolonged running - an extended study

Manual therapy (MT) and intermittent pneumatic compression (IPC) are recovery methods used by endurance athletes with little evidence supporting effectiveness. This randomized controlled trial evaluated effectiveness of four daily post-race treatments of a specific MT protocol and IPC compared with supine rest on recovery following an ultramarathon among 56 ultramarathoners. Groups were comparable across all characteristics examined, including post-race plasma creatine kinase concentration. Subject completed timed 400 m runs before the race and on days three, five, seven and 14 post- race, and also provided muscle pain and soreness ratings and fatigue scores immediately before and after treatments, and during the 14 days post- race. Daily subjective measures and 400 m run times were not improved by either treatment, but both treatments reduced (p < .05) muscular fatigue scores acutely after treatment following the race and on post-race day 1, and MT improved (p < .05) muscle pain and soreness acutely following the race.

Concomitant external pneumatic compression treatment with consecutive days of high intensity interval training reduces markers of proteolysis

PURPOSE

To compare the effects of external pneumatic compression (EPC) and sham when used concurrently with high intensity interval training (HIIT) on performance-related outcomes and recovery-related molecular measures.

METHODS

Eighteen recreationally endurance-trained male participants (age: 21.6 ± 2.4 years, BMI: 25.7 ± 0.5 kg/m², VO_2peak: 51.3 ± 0.9 mL/kg/min) were randomized to balanced sham and EPC treatment groups. Three consecutive days of HIIT followed by EPC/sham treatment (Days 2-4) and 3 consecutive days of recovery (Days 5-7) with EPC/sham only on Days 5-6 were employed. Venipuncture, flexibility and pressure-to-pain threshold (PPT) measurements were made throughout. Vastus lateralis muscle was biopsied at PRE (i.e., Day 1), 1-h post-EPC/sham treatment on Day 2 (POST1), and 24-h post-EPC/sham treatment on Day 7 (POST2). 6-km run time trial performance was tested at PRE and POST2.

RESULTS

No group × time interaction was observed for flexibility, PPT, or serum measures of creatine kinase (CK), hsCRP, and 8-isoprostane. However, there was a main effect of time for serum CK (p = 0.005). Change from PRE in 6-km run times at POST2 were not significantly different between groups. Significant between-groups differences existed for change from PRE in atrogin-1 mRNA (p = 0.018) at the POST1 time point (EPC: - 19.7 ± 8.1%, sham: + 7.7 ± 5.9%) and atrogin-1 protein concentration (p = 0.013) at the POST2 time point (EPC: - 31.8 ± 7.5%, sham: + 96.0 ± 34.7%). In addition, change from PRE in poly-Ub proteins was significantly different between groups at both the POST1 (EPC: - 26.0 ± 10.3%, sham: + 34.8 ± 28.5%; p = 0.046) and POST2 (EPC: - 33.7 ± 17.2%, sham: + 21.4 ± 14.9%; p = 0.037) time points.

CONCLUSIONS

EPC when used concurrently with HIIT and in subsequent recovery days reduces skeletal muscle markers of proteolysis.

Does external pneumatic compression treatment between bouts of overreaching resistance training sessions exert differential effects on molecular signaling and performance-related variables compared to passive recovery? An exploratory study

Purpose

We sought to compare the effects of external pneumatic compression (EPC) and sham when used concurrently with resistance training on performance-related outcomes and molecular measures related to recovery.

Methods

Twenty (N = 20) resistance-trained male participants (aged 21.6±2.4 years) were randomized to balanced sham or EPC intervention groups. The protocol consisted of 3 consecutive days of heavy, voluminous back squat exercise followed by EPC/sham treatment (Days2-4) and 3 consecutive days of recovery (Days5-7) with EPC/sham only on Days5-6. On Day1 (PRE), and Days3-7, venipuncture, flexibility and pressure-to-pain threshold (PPT) measures were performed. Vastsus lateralis muscle tissue was biopsied at PRE, 1-h post-EPC/sham treatment on Day2 (POST1) and 24-h post-EPC/sham treatment on Day7 (POST2). Isokinetic peak torque was assessed at PRE and POST2.

Results

Peak isokinetic strength did not change from PRE to POST2 in either group. The PPT was significantly lower on Days3-6 with sham, indicating greater muscle soreness, though this was largely abolished in the EPC group. A significant decrease in flexibility with sham was observed on Day3 (+16.2±4.6% knee joint angle; P<0.01) whereas there was no change with EPC (+2.8±3.8%; P>0.01). Vastus lateralis poly-ubiquitinated proteins significantly increased at the POST2 time point relative to PRE with sham (+66.6±24.6%; P<0.025) and were significantly greater (P<0.025) than those observed with EPC at the same time point (-18.6±8.5%). 4-hydroxynonenal values were significantly lower at POST2 relative to PRE with EPC (-16.2±5.6%; P<0.025) and were significantly lower (P<0.025) than those observed with sham at the same time point (+11.8±5.9%).

Conclusion

EPC mitigated a reduction in flexibility and PPT that occurred with sham. Moreover, EPC reduced select skeletal muscle oxidative stress and proteolysis markers during recovery from heavy resistance exercise.

Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report

Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

A Randomized Controlled Trial of Massage and Pneumatic Compression for Ultramarathon Recovery

Study Design Randomized controlled trial. Background Postexercise recovery techniques are widely used, but little research has examined their effectiveness. Objectives To examine the effectiveness of massage and pneumatic compression on recovery from a 161-km ultramarathon. Methods Participants in the 2015 161-km Western States Endurance Run were randomized to a 20-minute postrace intervention of massage, intermittent sequential pneumatic compression, or supine rest. Each subject completed two 400-m runs at maximum speed before the race and on days 3 and 5 after the race, and also provided muscle pain and soreness ratings and overall muscular fatigue scores before and for 7 days after the race. Results Among the 72 runners who finished the race and completed the study, comparison among intervention groups revealed no significant group or interaction effect on 400-m run time, but there was a significant (P<.0001) time effect. Immediately posttreatment, massage resulted in lower muscle pain and soreness ratings compared with the supine-rest control condition (P<.0001), while both massage (P<.0001) and pneumatic compression (P<.01) resulted in lower overall muscular fatigue scores compared with the control group. There were no significant differences between groups in any outcome 1 to 7 days after the race. Conclusion Single 20-minute sessions of postrace massage and intermittent sequential pneumatic compression provide some immediate subjective benefit. There is no evidence, however, that such treatments provide extended subjective or functional benefits of clinical importance. The trial was registered at www.clinicaltrials.gov (NCT02530190). Level of Evidence Therapy, level 1b. J Orthop Sports Phys Ther 2016;46(5):320-326. Epub 23 Mar 2016. doi:10.2519/jospt.2016.6455.

A single 60-min bout of peristaltic pulse external pneumatic compression transiently upregulates phosphorylated ribosomal protein s6

We investigated whether a single 60-min bout of whole leg, peristaltic pulse external pneumatic compression (EPC) altered select growth factor-related mRNAs and/or various phospho(p)-proteins related to cell growth, proliferation, inflammation and apoptosis signalling (e.g. Akt-mTOR, Jak-Stat). Ten participants (8 males, 2 females; aged 22·2 ± 0·4 years) reported to the laboratory 4 h post-prandial, and vastus lateralis muscle biopsies were obtained prior to (PRE), 1 h and 4 h post-EPC treatment. mRNA expression was analysed using real-time RT-PCR and phosphophorylated and cleaved proteins were analysed using an antibody array. No changes in selected growth factor-related mRNAs were observed following EPC. All p-proteins significantly altered by EPC decreased, except for p-rps6 (Ser235/236) which increased 31% 1 h post-EPC compared to PRE levels (P = 0·016). Notable decreases also included p-BAD (Ser112; -28%, P = 0·004) at 4 h post-EPC compared to PRE levels. In summary, an acute bout of EPC transiently upregulates p-rps6 as well as affecting other markers in the Akt-mTOR signalling cascade. Future research should characterize whether chronic EPC application promotes alterations in lower-limb musculature and/or enhances exercise-induced training adaptations.

Preconditioning with peristaltic external pneumatic compression does not acutely improve repeated Wingate performance nor does it alter blood lactate concentrations during passive recovery compared with sham

Application of dynamic external pneumatic compression (EPC) during recovery from athletic activities has demonstrated favorable effects on flexibility, soreness, swelling, and blood lactate (BLa) concentrations. However, the effects of "preconditioning" with a peristaltic pulse EPC device on subsequent performance and BLa concentrations have not been characterized. Herein, we demonstrate that pretreatment for 30 min with EPC has no effect on subsequent supramaximal exercise performance or BLa concentrations during passive recovery.