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

Efficacy of Self-Natural Posture Exercise (SNPE) programs on chronic low back pain: A randomized controlled feasibility trial with waitlist control

BACKGROUND

Low back pain (LBP) is a significant source of disability and decreased quality of life. The Self-Natural Posture Exercise (SNPE) intervention can be used effectively in many cases, but feasibility and impact has not been fully explored.

OBJECTIVE

The current study explores the feasibility and efficacy of face-to-face (FtF) and virtual (Vir) SNPE programs on chronic low back pain.

METHODS

This is a randomized single-blinded waitlist control study with 10 participants in the FtF group (age 45.8 ± 2.89) and 9 in the Vir group (age 52.2 ± 2.3). Participants had low to moderate low back pain for > 3 months. Those who would eventually become the Vir group served initially as a waitlist control (Con) group. The FtF group received 12 weeks of in-person exercise training sessions conducted and the Vir group received weekly recorded training videos created by and featuring the same instructor. Measured outcomes included feasibility assessed by rate of retention and rate of attendance, level of low back pain (Oswestry Disability Index, Visual Analogue Scale), quality of life (36-Item Short Form Health Survey 1.0), muscular pressure pain threshold, and muscle tone. Analysis was done via repeated measures ANOVA and Wilcoxon tests.

RESULTS

Rates of retention were 80% in the FtF group and 78% in the Vir group. Attendance rates were 88% in the FtF group and 60% in the Vir group. ODI, VAS, and some SF-36 domains improved in both the FtF and Vir groups. Overall, the FtF group improved in more domains and by a larger degree than the Vir group and both groups improved relative to Con.

CONCLUSION

A 12-week SNPE program, done virtually or in person, shows promise in improving ODI, VAS, and some SF-36 domains. FtF appears to be more effective. Future studies would benefit from sampling a larger and more diverse population.

Comparative Efficacy of Robotic and Manual Massage Interventions on Performance and Well-Being: A Randomized Crossover Trial

BACKGROUND

Manual massage (MM) interventions can improve psychophysiological states of relaxation and well-being. In this context, robotic massage (RM) represents a promising, but currently understudied, solution.

HYPOTHESIS

Both MM and RM would improve flexibility of the hamstrings and lumbopelvic muscles and promote a psychophysiological state of relaxation through decreased sympathetic activity.

STUDY DESIGN

Single-blind randomized crossover trial.

LEVEL OF EVIDENCE

Level 2.

METHODS

A total of 21 participants experienced 2 massage interventions targeting back soft tissues. During a first condition, the intervention was performed by a physical therapist, whereas during a second condition the intervention was performed by a robot. We collected objective and subjective indexes of performances and well-being before and after each massage intervention. We also collected physical therapists' self-reports of perceived fatigue, tension, and ability to maintain the massage routine.

RESULTS

Skin conductance decreased from the pretest to the posttest in both conditions (partial R2 = 0.44, 95% CI [0.30, 1.00], P < 0.01), although the decrease was more pronounced after MM. Whereas both interventions were associated with improved subjective sensations, eg, pain, warmth, well-being (partial R2 = 0.08, 95% CI [0.06, 1.00], P < 0.01), MM yielded additional benefits compared with RM. The physical therapist reported greater fatigue and tension and reduced perceived massage efficiency along with repeated massage interventions. MM outperformed RM to elicit a psychophysiological state of relaxation.

CONCLUSION

RM exhibited a pattern of changes comparable with that of MM, for both objective and subjective indexes of relaxation and well-being.

CLINICAL RELEVANCE

RM could represent a prophylactic option to prevent the onset of counterproductive fatigability in physical therapists.

A study on robot force control based on the GMM/GMR algorithm fusing different compensation strategies

To address traditional impedance control methods' difficulty with obtaining stable forces during robot-skin contact, a force control based on the Gaussian mixture model/Gaussian mixture regression (GMM/GMR) algorithm fusing different compensation strategies is proposed. The contact relationship between a robot end effector and human skin is established through an impedance control model. To allow the robot to adapt to flexible skin environments, reinforcement learning algorithms and a strategy based on the skin mechanics model compensate for the impedance control strategy. Two different environment dynamics models for reinforcement learning that can be trained offline are proposed to quickly obtain reinforcement learning strategies. Three different compensation strategies are fused based on the GMM/GMR algorithm, exploiting the online calculation of physical models and offline strategies of reinforcement learning, which can improve the robustness and versatility of the algorithm when adapting to different skin environments. The experimental results show that the contact force obtained by the robot force control based on the GMM/GMR algorithm fusing different compensation strategies is relatively stable. It has better versatility than impedance control, and the force error is within ~±0.2 N.

Is foam rolling as effective as its popularity suggests? A randomised crossover study exploring post-match recovery in female basketball

This study aimed to assess the effectiveness of foam rolling as a post-match recovery tool in basketball. Using a crossover design, 13 female players completed two simulated matches, followed by foam rolling (FR) or placebo (CON). Countermovement jump height (CMJ), heart rate variability (Ln-rMSSD), muscle soreness (VAS), perceived recovery (TQR) and fatigue (Rating-of-Fatigue) were recorded at pre-match, post-match, post-recovery and 24 h post-match. No significant effect of time*intervention and intervention were found for any variable (p > 0.05), while a significant effect of time (p < 0.01) was reported for all variables. Post-hoc analyses revealed lower CMJ and Ln-rMSSD at post-match compared with all other time points (p < 0.001), increases in pre-match VAS scores at all subsequent time points (p < 0.01), and worse TQR and Rating-of-Fatigue scores from pre-to-post-match and pre-match-to-post-recovery (p < 0.01), except for unchanged TQR values from pre-match-to-post-recovery in FR (p > 0.05). Overall, the present data suggest that foam rolling was generally ineffective for improving post-exercise recovery in female basketball players after a single match. Future research investigating the effectiveness of foam rolling in players of different sex, age and/or competitive level is warranted to provide further insight on the topic.

Effects of Various Physical Interventions on Reducing Neuromuscular Fatigue Assessed by Electromyography: A Systematic Review and Meta-Analysis

Introduction: Various interventions have been applied to improve recovery from muscle fatigue based on evidence from subjective outcomes, such as perceived fatigue and soreness, which may partly contribute to conflicting results of reducing muscle fatigue. There is a need to assess the effectiveness of various intervention on reducing neuromuscular fatigue assessed by a quantitative outcome, such as electromyography (EMG). The objective of this review and meta-analysis was to evaluate the effectiveness of different interventions and intervention timing for reducing fatigue rates during exercise. Methods: The literature was searched from the earliest record to March 2021. Eighteen studies with a total of 87 data points involving 281 participants and seven types of interventions [i.e., active recovery (AR), compression, cooling, electrical stimulation (ES), light-emitting diode therapy (LEDT), massage, and stretching] were included in this meta-analysis. Results: The results showed that compression (SMD = 0.28; 95% CI = -0.00 to 0.56; p = 0.05; I ² = 58%) and LEDT (SMD = 0.49; 95% CI = 0.11 to 0.88; p = 0.01; I ² = 52%) have a significant recovery effect on reducing muscle fatigue. Additionally, compression, AR, and cooling have a significant effect on reducing muscle fatigue when conducted during exercise, whereas a non-effective trend when applied after exercise. Discussion: This meta-analysis suggests that compression and LEDT have a significant effect on reducing muscle fatigue. The results also suggest that there is a significant effect or an effective trend on reducing muscle fatigue when compression, AR, cooling, and ES are applied during exercise, but not after exercise.

Foam Rolling Elicits Neuronal Relaxation Patterns Distinct from Manual Massage: A Randomized Controlled Trial

The present double-blinded, randomized controlled study sought to compare the effects of a full-body manual massage (MM) and a foam rolling (FR) intervention on subjective and objective indexes of performance and well-being. A total of 65 healthy individuals were randomly allocated to an FR, MM, or a control group who received a cognitively oriented relaxation routine. Self-report ratings of perceived anxiety, muscle relaxation, and muscle pain were used to index changes in affect and physical sensations. The sit-and-reach and toe-touch tests, as well as a mental calculation task, were used to index motor and cognitive performances, respectively. We also conducted resting-state electroencephalography and continuous skin conductance recordings before and after the experimental intervention. Both FR and MM groups exhibited neural synchronization of alpha and beta oscillations during the posttest. Skin conductance increased from the pretest to the posttest in the relaxation group, but decreased in the FR group. All interventions improved range of motion, although only the MM group outperformed the relaxation group for the toe-touch performance. MM was associated with reduced muscle pain and increased muscle relaxation. Reduced perceived anxiety after the intervention was observed in the FR group only. Overall, MM and FR both improved objective and subjective indexes of performance and well-being. Differences between the two massage interventions are discussed in relation to the effects of pressure stimulation on autonomic regulations and the proactive vs. retroactive nature of FR, compared to MM.

Robotic Applications in Orthodontics: Changing the Face of Contemporary Clinical Care

The last decade (2010-2021) has witnessed the evolution of robotic applications in orthodontics. This review scopes and analyzes published orthodontic literature in eight different domains: (1) robotic dental assistants; (2) robotics in diagnosis and simulation of orthodontic problems; (3) robotics in orthodontic patient education, teaching, and training; (4) wire bending and customized appliance robotics; (5) nanorobots/microrobots for acceleration of tooth movement and for remote monitoring; (6) robotics in maxillofacial surgeries and implant placement; (7) automated aligner production robotics; and (8) TMD rehabilitative robotics. A total of 1,150 records were searched, of which 124 potentially relevant articles were retrieved in full. 87 studies met the selection criteria following screening and were included in the scoping review. The review found that studies pertaining to arch wire bending and customized appliance robots, simulative robots for diagnosis, and surgical robots have been important areas of research in the last decade (32%, 22%, and 16%). Rehabilitative robots and nanorobots are quite promising and have been considerably reported in the orthodontic literature (13%, 9%). On the other hand, assistive robots, automated aligner production robots, and patient robots need more scientific data to be gathered in the future (1%, 1%, and 6%). Technological readiness of different robotic applications in orthodontics was further assessed. The presented eight domains of robotic technologies were assigned to an estimated technological readiness level according to the information given in the publications. Wire bending robots, TMD robots, nanorobots, and aligner production robots have reached the highest levels of technological readiness: 9; diagnostic robots and patient robots reached level 7, whereas surgical robots and assistive robots reached lower levels of readiness: 4 and 3, respectively.

Effects of self-myofascial release interventions with or without sliding pressures on skin temperature, range of motion and perceived well-being: a randomized control pilot trial

Background

Self-myofascial release is an emerging technique in strength and conditioning. Yet, there is no consensus regarding optimal practice guidelines. Here, we investigated the acute effects of various foam rolling interventions targeting quadriceps muscles, with or without sliding pressures.

Methods

We conducted a blinded randomized control pilot trial in 42 healthy weightlifting athletes over 4 weeks. Participants were randomly allocated to one of the four intervention (120 s massage routine) groups: foam rolling, roller massager, foam rolling with axial sliding pressures, foam rolling with transverse sliding pressures. Knee range of motion, skin temperature and subjective scores of the perceived heat, range of motion, muscle pain and relaxation were the dependent variables. Measurements were carried on before, after and up to 15 min (follow-up) after the massage intervention.

Results

The range of motion increased immediately after the various foam rolling interventions (+ 10.72%, 95% CI 9.51 to 11.95, p < 0.001), but progressively returned back to the pre-intervention baseline along within the 15 min post-intervention. Foam rolling was the most effective intervention to increase skin temperature from thermographic measures (+ 14.06%, 95% CI 10.97 to 17.10, p < 0.001), while the increase in perceived heat was comparable in all experimental groups (107%, 95% CI 91.08 to 122.61, p < 0.001).

Conclusions

Subjective indexes of heat, range of motion, muscle pain and relaxation improved immediately after the intervention, but also gradually returned to the pre-intervention baseline. Overall, combining foam rolling with sliding pressures did not yield additional benefits from objective measures.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-021-00270-8.

Evaluating the effects of embedded self-massage practice on strength performance: A randomized crossover pilot trial

Background

Self-administered massage interventions with a roller massager are commonly used as part of warm-ups and post-workout recovery routines. There is yet no clear consensus regarding the practical guidelines for efficient embedded interventions.

Objectives

The present randomized crossover pilot trial aimed at examining the effects of a rolling intervention with a roller massager embedded within the rests periods of a resistance training protocol. The rolling intervention targeted quadriceps muscles.

Setting

Participants (n = 14) performed two resistance training protocols expected to elicit momentary muscle failure. The protocol consisted in 10 sets of 10 rest-pause repetitions of back squats, with a poundage set up at 50% of the maximal one-repetition. Two min were allocated to recovery between sets. During the recovery periods, participants completed a rolling routine with a roller massager for 60 s (Roller-massager), or underwent passive recovery (Control). The total workload, concentric power, thigh circumference rate of perceived exertion (RPE) and delayed onset of muscle soreness (DOMS) from 24 h to 120 h after completion of the protocol were the dependent variables.

Results

Roller-massager was associated with a reduction in total workload (-11.6%), concentric power (-5.1%) and an increase in perceived exertion compared to Control (p < 0.05). Roller-massager was also associated with reduced thigh circumference after the resistance training protocol, indicating reduced muscle swelling, and reduced DOMS 24 h to 120 h post-workout (p < 0.001).

Conclusion

These findings support that embedded rolling with a roller massager hinders performance and increases effort perception. Embedded interventions may not be suitable during conditioning periods designed to maximize training intensity.