Therapeutic effects of massage and electrotherapy on muscle tone, stiffness and muscle contraction following gastrocnemius muscle fatigue

Dose Escalation Can Enhance the Therapeutic Potential of Radial Extracorporeal Shock-Wave Therapy in the Treatment of Plantar Fasciitis in Runners

Background and Objectives: Treatment of chronic plantar fasciitis is challenging given that there are various of available treatment options with no clear gold standard. The aim of the study was to examine the dose-escalation effect of rESWT on the biomechanical parameters of the plantar fascia and pain ailments. Materials and Methods: In the experimental group (n = 30), the intensity of the shock wave was increased every two subsequent treatment sessions. In the control group (n = 32), the treatment parameters were not changed. In both groups, six treatments were performed, with two treatment sessions a week. In order to assess the biomechanical parameters of the plantar fascia, myotonometric measurements were performed. The pain intensity was assessed using the Visual Analog Scale (VAS). Results: The tension of the plantar fascia attachment in the experimental group decreased from 27.69 ± 2.06 [Hz] before treatment to 26.29 ± 1.69 [Hz] after treatment (p = 0.009) and to 26.03 ± 2.15 [Hz] 1 month after the beginning of treatment (p = 0.003). In the control group, the frequency results did not change significantly (p > 0.05). Flexibility increased in both groups. The test results before treatment and 1 month after the beginning of the treatment showed statistical significance in the experimental group (p = 0.001) vs. (p = 0.002) in the control group. The differences were not statistically significant between groups (p > 0.05). The assessment of pain intensity carried out 1 month after the end of treatment in the experimental group amounted to 3.14 ± 2.28 points, which was statistically significantly lower compared to that in the control group, where it amounted to 5.14 ± 1.92 points. (p < 0.001). Conclusions: The use of rESWT performed with an increasing intensity of impact during subsequent treatment procedures demonstrated greater effectiveness in improving the biomechanical parameters of the plantar fascia and was also more effective in reducing the pain ailments. Our results are encouraging. The dose escalation in the treatment cycle is worth considering. To prove that this method of treatment is more effective, a randomized controlled trial should be carried out on a representative sample.

The Effects of the "Sling Shot" Device on Bench Press Performance, Mechanical Properties of Muscle, and Movement Kinematics

ABSTRACT

Wojdała, G and Krzysztofik, M. The effects of the "sling shot" device on bench press performance, mechanical properties of muscle, and movement kinematics. J Strength Cond Res 37(4): 780-786, 2023-This study aimed to evaluate the influence of the sling shot support device at various external loads and intensities of effort, taking into account acute changes in power performance, mechanical muscle properties, and bench press kinematics. For this purpose, 12 resistance-trained men (age: 27.1 ± 4.2 years, body mass: 90.3 ± 16.9 kg, bench press [BP] 1 repetition maximum [1RM]: 112.7 ± 23.1 kg) (resistance training experience: 6.9 ± 3.8 years) participated in the study. Each subject completed 2 experimental sessions that differed in the use of the sling shot (SS) or nonuse (CONT) of the SS and an appropriate external load. The 2 experimental sessions consisted of the 1RM test, 3 sets of 2 repetitions of BP with the load increased in each set (50-70-90% 1RM), and a fourth set of the BP efforts to muscle failure with a 70% 1RM load. Before and after each set, the changes in triceps brachii oscillation frequency and stiffness were assessed by means of myotonometry. Results indicated a significant main effect of the SS to increase peak power ( p < 0.0001, η 2 = 0.733). Furthermore, a significantly higher 1RM (129 ± 26 vs. 113 ± 23 kg, p < 0.001, effect size [ES]: 0.63), number of repetitions (15 ± 3 vs. 13 ± 2, p = 0.013, ES: 0.76), and time under tension (34 ± 10 vs. 29 ± 6 seconds, p = 0.017, ES: 0.59) were found during the set to failure for SS in comparison to the CONT condition. Moreover, there was a significant main effect of time to increase oscillation frequency ( p = 0.001; η 2 = 0.666) and stiffness ( p = 0.002; η 2 = 0.613) from pre- to postset measure. In addition, the main effect of the side ( p = 0.034; η 2 = 0.348) was reported to show higher stiffness on the dominant than on the nondominant side in the CONT condition. The results suggest that an independent 1RM measurement and a correspondingly higher workload are required to take full advantage of the SS device. Moreover, the SS can also be used successfully to increase training volume and the involvement of nondominant limbs during a bench press.

Effects of Therapeutic Calf Massage on Cardiac Autonomic Function in Healthy Volunteers-a Pilot Study

Background

Calf massage is a therapeutic intervention that improves circulation and relieves us from pain & tightness. The calf massage also improves autonomic performance by modulating the vagal tone of the cardiovascular system. Therefore, the current study was intended to determine therapeutic calf massage on cardio autonomic activity in healthy subjects.

Objective

To assess the immediate effect of a single 20-min session of calf massage on cardiac autonomic modulation through heart rate variability (HRV) measurement.

Materials & Methods

In this study, 26 apparent healthy female participants aged between 18 and 25 years participated. Massage over the calf muscles on both legs for 20 min was performed, and resting cardiovascular parameters and HRV parameters were measured at baseline, immediately after the massage, and during the recovery periods (10 and 30 min after the massage). Data were analyzed using one-way ANOVA followed with post hoc analysis.

Results

Immediately after the massage intervention, heart rate (HR), systolic (SBP), and diastolic (DBP) blood pressure were decreased (p < .01), and the reduction was persisted at 10 min and 30 min of the recovery period (p < .01). In HRV parameters, the root mean square of successive differences (RMSSD) and high-frequency normalized unit (HF n.u.) increased, and low frequency (LF n.u.) decreased after the massage, and at the 10 and 30 min of the recovery period.

Conclusion

The present study reports suggest a significant reduction in heart rate and blood pressure after the massage therapy. A drop in sympathetic tone and raise in parasympathetic tone can also attribute to the therapeutic effect.

Dysfunction of the Lenticular Nucleus Is Associated with Dystonia in Wilson's Disease

Dysfunction of the lenticular nucleus is thought to contribute to neurological symptoms in Wilson's disease (WD). However, very little is known about whether and how the lenticular nucleus influences dystonia by interacting with the cerebral cortex and cerebellum. To solve this problem, we recruited 37 WD patients (20 men; age, 23.95 ± 6.95 years; age range, 12-37 years) and 37 age- and sex-matched healthy controls (HCs) (25 men; age, 25.19 ± 1.88 years; age range, 20-30 years), and each subject underwent resting-state functional magnetic resonance imaging (RS-fMRI) scans. The muscle biomechanical parameters and Unified Wilson Disease Rating Scale (UWDRS) were used to evaluate the level of dystonia and clinical representations, respectively. The lenticular nucleus, including the putamen and globus pallidus, was divided into 12 subregions according to dorsal, ventral, anterior and posterior localization and seed-based functional connectivity (FC) was calculated for each subregion. The relationships between FC changes in the lenticular nucleus with muscle tension levels and clinical representations were further investigated by correlation analysis. Dystonia was diagnosed by comparing all WD muscle biomechanical parameters with healthy controls (HCs). Compared with HCs, FC decreased from all subregions in the putamen except the right ventral posterior part to the middle cingulate cortex (MCC) and decreased FC of all subregions in the putamen except the left ventral anterior part to the cerebellum was observed in patients with WD. Patients with WD also showed decreased FC of the left globus pallidus primarily distributed in the MCC and cerebellum and illustrated decreased FC from the right globus pallidus to the cerebellum. FC from the putamen to the MCC was significantly correlated with psychiatric symptoms. FC from the putamen to the cerebellum was significantly correlated with muscle tension and neurological symptoms. Additionally, the FC from the globus pallidus to the cerebellum was also associated with muscle tension. Together, these findings highlight that lenticular nucleus-cerebellum circuits may serve as neural biomarkers of dystonia and provide implications for the neural mechanisms underlying dystonia in WD.

Acute Effects of Percussive Massage Treatment on Drop Jump Performance and Achilles Tendon Stiffness

This study aimed to investigate the impact of Achilles tendon (AT) mechanical percussion massage (PM) on the passive stiffness of that tendon and subsequent drop jump kinematics. Eleven physically active participants performed two conditions in random order: (i) 60 s of PM applied to each AT (EXP) and (ii) no PM (CTRL). Measurements were performed 5 min before, immediately after, and 5 min following the completion of the PM. In the CTRL, measurements were performed at the same time point but no massage was applied. The two-way ANOVA indicated that there was no statistically significant interaction effect on contact time (p = 0.786), reactive strength index (p = 0.914), and relative peak power (p = 0.896). However, a statistically significant interaction on peak velocity (p = 0.046) and jump height (p = 0.03) was found. Despite that, there was no significant post-hoc comparisons for jump height, it slightly decreased 5 min post-PM (p = 0.136; ES = -0.25; Δ = -3.1%) compared with the CTRL condition (p = 1.00; ES = 0.11; Δ = +1.5%). Friedman's test did not show significant differences in dominant (p = 0.073) and non-dominant limb (p = 0.091) AT stiffness. Although not significant, numerically, the dominant limb AT (p = 0.126; ES = -0.64; Δ = -7.8%) had a larger reduction in stiffness immediately post-PM compared with the non-dominant limb (p = 0.294; ES = -0.26; Δ = -3.6%). The results of this study indicated the temporary effect of PM on the reduction in tissue stiffness. Moreover, these findings show that a mechanical PM might slightly hinder subsequent explosive athletic performance.

Effect of osteopathic techniques on human resting muscle tone in healthy subjects using myotonometry: a factorial randomized trial

Musculoskeletal disorders (MSDs) are highly prevalent, burdensome, and putatively associated with an altered human resting muscle tone (HRMT). Osteopathic manipulative treatment (OMT) is commonly and effectively applied to treat MSDs and reputedly influences the HRMT. Arguably, OMT may modulate alterations in HRMT underlying MSDs. However, there is sparse evidence even for the effect of OMT on HRMT in healthy subjects. A 3 × 3 factorial randomised trial was performed to investigate the effect of myofascial release (MRT), muscle energy (MET), and soft tissue techniques (STT) on the HRMT of the corrugator supercilii (CS), superficial masseter (SM), and upper trapezius muscles (UT) in healthy subjects in Hamburg, Germany. Participants were randomised into three groups (1:1:1 allocation ratio) receiving treatment, according to different muscle-technique pairings, over the course of three sessions with one-week washout periods. We assessed the effect of osteopathic techniques on muscle tone (F), biomechanical (S, D), and viscoelastic properties (R, C) from baseline to follow-up (primary objective) and tested if specific muscle-technique pairs modulate the effect pre- to post-intervention (secondary objective) using the MyotonPRO (at rest). Ancillary, we investigate if these putative effects may differ between the sexes. Data were analysed using descriptive (mean, standard deviation, and quantiles) and inductive statistics (Bayesian ANOVA). 59 healthy participants were randomised into three groups and two subjects dropped out from one group (n = 20; n = 20; n = 19-2). The CS produced frequent measurement errors and was excluded from analysis. OMT significantly changed F (-0.163 [0.060]; p = 0.008), S (-3.060 [1.563]; p = 0.048), R (0.594 [0.141]; p < 0.001), and C (0.038 [0.017]; p = 0.028) but not D (0.011 [0.017]; p = 0.527). The effect was not significantly modulated by muscle-technique pairings (p > 0.05). Subgroup analysis revealed a significant sex-specific difference for F from baseline to follow-up. No adverse events were reported. OMT modified the HRMT in healthy subjects which may inform future research on MSDs. In detail, MRT, MET, and STT reduced the muscle tone (F), decreased biomechanical (S not D), and increased viscoelastic properties (R and C) of the SM and UT (CS was not measurable). However, the effect on HRMT was not modulated by muscle-technique interaction and showed sex-specific differences only for F.Trial registration German Clinical Trial Register (DRKS00020393).

Acute Effects of Different Intensities during Bench Press Exercise on the Mechanical Properties of Triceps Brachii Long Head

This study aimed to analyze acute changes in the muscle mechanical properties of the triceps brachii long head after bench press exercise performed at different external loads and with different intensities of effort along with power performance. Ten resistance-trained males (age: 27.7 ± 3.7 yr, body mass: 90.1 ± 17.1 kg, height: 184 ± 4 cm; experience in resistance training: 5.8 ± 2.6 yr, relative one-repetition maximum (1RM) in the bench press: 1.23 ± 0.22 kg/body mass) performed two different testing conditions in a randomized order. During the experimental session, participants performed four successive sets of two repetitions of the bench press exercise at: 50, 70, and 90% 1RM, respectively, followed by a set at 70% 1RM performed until failure, with a 4 min rest interval between each set. Immediately before and after each set, muscle mechanical properties of the dominant limb triceps brachii long head were assessed via a Myoton device. To determine fatigue, peak and average barbell velocity were measured at 70% 1RM and at 70% 1RM until failure (only first and second repetition). In the control condition, only muscle mechanical properties at the same time points after the warm-up were assessed. The intraclass correlation coefficients indicated “poor” to “excellent” reliability for decrement, relaxation time, and creep. Therefore, these variables were excluded from further analysis. Three-way ANOVAs (2 groups × 2 times × 4 loads) indicated a statistically significant group × time interaction for muscle tone (p = 0.008). Post hoc tests revealed a statistically significant increase in muscle tone after 70% 1RM (p = 0.034; ES = 0.32) and 90% 1RM (p = 0.011; ES = 0.56). No significant changes were found for stiffness. The t-tests indicated a significant decrease in peak (p = 0.001; ES = 1.02) and average barbell velocity (p = 0.008; ES = 0.8) during the first two repetitions of a set at 70% 1RM until failure in comparison to the set at 70% 1RM. The results indicate that low-volume, high-load resistance exercise immediately increases muscle tone but not stiffness. Despite no significant changes in the mechanical properties of the muscle being registered simultaneously with a decrease in barbell velocity, there was a trend of increased muscle tone. Therefore, further studies with larger samples are required to verify whether muscle tone could be a sensitive marker to detect acute muscle fatigue.

Efficacy of electroconvulsive therapy in Parkinson's disease: a clinical trial

Motor and psychiatric symptoms in patients with Parkinson's disease (PD) constitute some of the most problematic issues for both the patients and their caregivers. This study evaluated the short- and long-term efficacy of electroconvulsive therapy (ECT) in PD patients whose psychiatric symptoms had been exacerbated due to drug therapy. Fifteen PD patients were treated using an electroshock device at a range of 25-100 Joules over a period of 6 weeks, during 12 sessions. Motor and psychiatric symptoms of all patients were evaluated before conducting ECT as baseline, after 12 sessions of ECT at the 6^th week, and one month after completion of the treatment at the 10^th week. The results showed that the variables mentation, behavior, mood, performance of daily activities, and severity of motor and psychiatric symptoms, were significantly improved at the end of the 6^th and 10^th weeks when compared with the baseline. Moreover, the results revealed that the mean values were significantly different only for motor symptoms at the end of the study (10^th week) compared with the second time point. The current trial may indicate that ECT could potentially serve as a viable treatment for PD patients with refractory psychiatric symptoms. However, due to waning efficacy of ECT, it is recommended that PD patients undergo a conventional treatment in conjunction with periodic ECT sessions to ensure an optimal medical outcome.

Structural and mechanical properties of the Achilles tendon in senior badminton players: Operated vs. non-injured tendons

BACKGROUND

The aim of this study was to describe the differences in structural and mechanical properties between operated and non-injured Achilles tendons in senior badminton players who had had Achilles tendon surgery and had returned to play.

METHODS

Eighteen players (age = 48.9(10.0)years), assigned to the unilateral Achilles tendon rupture group and 177 non-injured players (age = 55.4(9.4)years), assigned to the control group. A Logiq®S8 ultrasound was used to study tendon structure and elastography index values and a Myoton®PRO hand-held myotonometer was used to record the stiffness of the Achilles tendon.

FINDINGS

In Achilles tendon rupture group, operated tendons showed higher values than non-injured ones in thickness (Operated = 9.03(2.67)mm vs. non-injured = 5.88(0.88)mm; P < 0.001), width (Operated = 18.44(3.20)mm vs. non-injured = 16.80(1.97)mm; P = 0.039), cross sectional area (Operated = 140.33(60.29)mm² vs. non-injured = 74.40(17.09)mm²; P < 0.001) and elastography index (Operated = 2.05(1.35)A.U. vs. non-injured = 1.47(0.62)A.U.; P = 0.025). The bilateral differences shown by the Achilles tendon rupture group were greater than the bilateral differences shown by the control group for thickness (P < 0.001), width (P = 0.001), cross sectional area (P < 0.001), tone (P = 0.006) and dynamic stiffness (Achilles tendon rupture group = 10.85(23.90)N∙m^-1. vs. control group = 0.18(18.83)N∙m^-1; P = 0.031).

INTERPRETATION

Surgery on the Achilles tendon and adaptation to the mobilisation and strength training during rehabilitation could provoke structural and mechanical differences compared to the non-injured tendon. Furthermore, the differences between both Achilles tendons in the Achilles tendon rupture group was higher than the asymmetry observed between dominant and non-dominant Achilles tendons in the control group. In addition, the higher logarithmic decrement values showed by non-injured tendons in the Achilles tendon rupture group could be a tendinous injury risk factor.

Mouthguard-effect of high-intensity weight training on masticatory muscle tone and stiffness in taekwondo athletes

This study aimed to analyze the effect of wearing a mouthguard or not on masticatory muscle tone and stiffness of male taekwondo athletes during high-intensity weight training. The participants were male taekwondo athletes and aged 18 to 22 years. We randomly divided 24 men into the control group (CON; without a mouthguard; n=12) and the experimental group (MOG; with a mouthguard; n=12). Masticatory muscle tone and stiffness were measured after weight training at a level of 70% of one-repetition maximum. As a result of this study, masticatory muscle tone was no different in intragroup and intergroup after experiment. In addition, although the masticatory muscle stiffness was significantly higher in the dominant side of the MOG, there was no difference in intergroup, intragroup, and interaction. Through this study, it is necessary to consider the selective wearing of a mouthguard according to the training methods when partially analyzed from the physiological point of view of the masticatory muscle of taekwondo athletes.

Biomechanical and viscoelastic properties of the ankle muscles in men with previous history of ankle sprain

In this study, we aimed to explore the impact of previous history of lateral ankle sprain on the mechanical and viscoelastic properties of the tibialis anterior (TA), peroneus longus (PL) and gastrocnemius lateralis (GL) and medialis (GM) in asymptomatic men. For this purpose, a group of 26 men with previous history of lateral ankle sprain (ASG) and a control group (CG) of 29 healthy counter-parts participated in this study. Tone, stiffness, elasticity and mechanical stress relaxation time were measured using a myotonometer in a single session. Higher tone was noted for TA and GL in ASG as compared to CG (effect size of Cohen's d = 0.57 [p = 0.04] and 0.59 [p = 0.04], respectively). Further, stiffness was higher in ASG than in CG for TA (d = 0.56; p = 0.04), PL (d = 0.58; p = 0.04) and GL (d = 0.63; p = 0.02). Stress relaxation time was also lower for the ASG compared to the CG for TA (d = 0.61; p = 0.03), PL (d = 0.55; p = 0.04) and GL (d = 0.68; p = 0.02). There were no significant differences between groups in elasticity (p > 0.05). GM experienced no significant changes after ankle sprain in any of the variables (p > 0.05). To conclude, previous history of lateral ankle sprain results in higher TA and GL muscle tone. Likewise, these muscles in addition to PL exhibit less deformation against resistance due to their increased stiffness, thus needing a shorter time to restore to their original shape after deformation.

Beneficial effects of a negative ion patch on eccentric exercise-induced muscle damage, inflammation, and exercise performance in badminton athletes

Complementary and alternative medicines (CAMs) are widely applied and accepted for therapeutic purposes because of their numerous benefits. Negative ion treatment belongs to one of the critical categories defined by the National Center for CAM, with such treatment capable of air purification and ameliorating emotional disorders (e.g., depression and seasonal affective disorder). Negative ions can be produced naturally and also by a material with activated energy. Exercise-induced muscle damage (EIMD) often occurs due to inadequate warm up, high-intensity exercise, overload, and inappropriate posture, especially for high-intensive competition. Few studies have investigated the effects of negative ion treatment on muscular injury in the sports science field. In the current study, we enrolled badminton athletes and induced muscle damage in them through eccentric exercise in the form of a high-intensity squat program. We evaluated the effects of negative ion patches of different intensities at three points (preexercise, postexercise, and recovery) by analyzing physiological indexes (tumor necrosis factor [TNF]-α, interleukin [IL]-6, IL-10, creatine kinase [CK], and lactate dehydrogenase [LDH] levels) and performing a functional assessment (a countermovement jump [CMJ] test). We found that a high-intensity negative ion patch could significantly reduce the levels of TNF-α, an injury-associated inflammatory cytokine, and related markers (CK and LDH). In addition, muscular overload-caused fatigue could be also ameliorated, as indicated by the functional CMJ test result, and related muscular characteristics (tone and stiffness) could be effectively improved. Thus, the negative ion treatment could effectively improve physiological adaption and muscular fatigue recovery after EIMD in the current study. The negative ion patch treatment can be further integrated into a taping system to synergistically fulfill exercise-induced damage protection and functional elevation. However, the effects of this treatment require further experimental validation.

Assessment of Passive Stiffness of Medial and Lateral Heads of Gastrocnemius Muscle, Achilles Tendon, and Plantar Fascia at Different Ankle and Knee Positions Using the MyotonPRO

Background

The aim of this study was to assess the passive stiffness of the medial and lateral gastrocnemius (MG and LG), Achilles tendon (AT), and plantar fascia (PF) at different ankle and knee positions.

Material/Methods

Stiffness was assessed using a portable hand-held device (MyotonPRO). In 30 healthy participants (15 males, 15 females) with the knee fully extended or flexed 90°, stiffness of the MG, LG, AT, and PF was measured at 50° plantar flexion, 0° (neutral position), and 25° dorsiflexion (not for AT) of the ankle joint by passive joint rotation.

Results

With the knee fully extended, passive dorsiflexion caused significant increase in muscle stiffness (P<0.001), whereas AT and PF stiffness increased with passive ankle dorsiflexion regardless of knee position (P<0.001). Increased stiffness was observed in MG compared to LG (P<0.001) and at the 3-cm site of AT compared to the 6-cm site (P<0.05). Stiffness was greater in LG compared to MG at −50° plantar flexion (P<0.001) and was greater in MG compared to LG at 25° dorsiflexion (P<0.05). Stiffness of AT increased in a distal-to-proximal pattern: 0 cm >3 cm >6 cm (P<0.001).

Conclusions

Stiffness assessed by use of the MyotonPRO was similar assessments using other techniques, suggesting that the MyotonPRO is capable of detecting the variations in stiffness of MG, LG, AT, and PF at different ankle and knee positions.