Comparison between 6-week foam rolling intervention program with and without vibration on rolling and non-rolling sides

The effects of a 6 week rolling and dynamic movement training intervention on tissue hardness, pain pressure threshold, knee range of motion and muscular strength

Foam Roller (FR) intervention is popular in sports and rehabilitation settings. Recently, we showed that conventional FR (FR_rolling) as well as compression of the target muscle (knee extensors) during joint movement using FR (FR_KM) have similar acute changes. The present study aimed to expand on these findings and compare the effects of a 6-week FR_rolling and FR_KM intervention on the passive and active properties of knee extensors. The participants were 36 healthy male university students (21.9 ± 1.1 years) who were randomly assigned to either controls, FR_rolling, or FR_KM. An intervention per session of 180-sec was performed 3-time/week for 6 weeks in both FR_rolling and FR_KM groups. Measurements were tissue hardness, pain pressure threshold (PPT) of knee extensors, knee flexion ROM, maximal voluntary isometric and concentric contraction before and after the intervention. PPT and knee flexion ROM were significantly increased in the FR_rolling and FR_KM groups, with no significant differences between the two groups. No significant changes were observed in tissue hardness, and muscle strength in all groups. Long-term interventions with FR_rolling and FR_KM could effectively increase knee flexion ROM and PPT similarly. Therefore, if difficulties from trunk stabilization or rolling during the FR-rolling occur, a simpler approach could be sustained through the FR_KM.

Adding vibration and non-vibration foam rolling to routine soccer training alters muscle strength, flexibility, and dynamic balance in young male semi-professional soccer players: a randomized, controlled comparative study

This study aimed to examine the effects of 6-week vibration (VFR) and non-vibration foam rolling (FR) on muscle strength, hamstrings-to-quadriceps (H:Q) ratio, flexibility, and dynamic balance in soccer players. Thirty-six players were included in the study. The players were randomly assigned to either VFR (n=12), FR (n=12), or control group (CG) (n=12). The players in VFR and FR groups performed VFR or FR thrice per week for 6 weeks. The CG did not receive any intervention. Pre- and post-test assessment included muscle strength, H:Q ratio, flexibility, and dynamic balance. Dominant extremity knee flexor and non-dominant extremity knee flexor and extensor muscle strength improved in VFR and FR groups (p<0.05). Flexibility and dynamic balance improved in VFR group (p<0.05). Both 6-week VFR and FR increased muscle strength without affecting H:Q ratio. VFR was more effective than FR for improving flexibility and dynamic balance. The results can be stunning for performance enhancement.

The merit of superimposed vibration for flexibility and passive stiffness: A systematic review with multilevel meta-analysis

BACKGROUND

Due to its high relevance in sports and rehabilitation, the exploration of interventions to further optimize flexibility becomes paramount. While stretching might be the most common way to enhance range of motion, these increases could be optimized by imposing an additional activation of the muscle, such as mechanical vibratory stimulation. While several original articles provide promising findings, contradictory results on flexibility and underlying mechanisms (e.g., stiffness), reasonable effect size (ES) pooling remains scarce. With this work we systematically reviewed the available literature to explore the possibility of potentiating flexibility, stiffness, and passive torque adaptations by superimposing mechanical vibration stimulation.

METHODS

A systematic search of 4 databases (Web of Science, MEDLINE, Scopus, and Cochrane Public Library) was conducted until December 2023 to identify studies comparing mechanical vibratory interventions with passive controls or the same intervention without vibration (sham) on range of motion and passive muscle stiffness in acute (immediate effects after single session) and chronic conditions (multiple sessions over a period of time). ES pooling was conducted using robust variance estimation via R to account for multiple study outcomes. Potential moderators of effects were analyzed using meta regression.

RESULTS

Overall, 65 studies (acute: 1162 participants, chronic: 788 participants) were included. There was moderate certainty of evidence for acute flexibility (ES = 0.71, p < 0.001) and stiffness (ES = -0.89, p = 0.006) effects of mechanical vibration treatments vs. passive controls without meaningful results against the sham condition (flexibility: ES = 0.20, p < 0.001; stiffness: ES = -0.19, p = 0.076). Similarly, moderate certainty of evidence was found for chronic vibration effects on flexibility (control: ES = 0.64, p = 0.043; sham: ES = 0.65, p < 0.001). Lack of studies and large outcome heterogeneity prevented ES pooling for underlying mechanisms.

CONCLUSION

Vibration improved flexibility in acute and chronic interventions compared to the stand-alone intervention, which can possibly be attributed to an accumulated mechanical stimulus through vibration. However, studies on biological mechanisms are needed to explain flexibility and stiffness effects in response to specific vibration modalities and timing.

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.

Static Stretch Training versus Foam Rolling Training Effects on Range of Motion: A Systematic Review and Meta-Analysis

BACKGROUND

Long-term static stretching as well as foam rolling training can increase a joint's range of motion (ROM). However, to date, it is not clear which method is the most effective for increasing ROM.

OBJECTIVE

The purpose of this systematic review and meta-analysis was to compare the effects of static stretching and foam rolling training on ROM.

METHODS

The literature search was performed in PubMed, Scopus, and Web of Science to find the eligible studies. Eighty-five studies (72 on static stretching; and 13 on foam rolling) were found to be eligible with 204 effect sizes (ESs). For the main analyses, a random-effect meta-analysis was applied. To assess the difference between static stretching and foam rolling, subgroup analyses with a mixed-effect model were applied. Moderating variables were sex, total intervention duration, and weeks of intervention.

RESULTS

Static stretch (ES =  - 1.006; p < 0.001), as well as foam rolling training (ES =  - 0.729; p = 0.001), can increase joint ROM with a moderate magnitude compared with a control condition. However, we did not detect a significant difference between the two conditions in the subgroup analysis (p = 0.228). When the intervention duration was ≤ 4 weeks, however, a significant change in ROM was shown following static stretching (ES =  - 1.436; p < 0.001), but not following foam rolling (ES =  - 0.229; p = 0.248). Thus, a subgroup analysis indicated a significant favorable effect with static stretching for increasing ROM compared with foam rolling (p < 0.001) over a shorter term (≤ 4 weeks). Other moderator analyses showed no significant difference between static stretch and foam rolling training on ROM.

CONCLUSIONS

According to the results, both static stretching and foam rolling training can be similarly recommended to increase joint ROM, unless the training is scheduled for ≤ 4 weeks, in which case static stretching demonstrates a significant advantage. More studies are needed with a high-volume foam rolling training approach as well as foam rolling training in exclusively female participants.

Discussing Conflicting Explanatory Approaches in Flexibility Training Under Consideration of Physiology: A Narrative Review

The mechanisms underlying range of motion enhancements via flexibility training discussed in the literature show high heterogeneity in research methodology and study findings. In addition, scientific conclusions are mostly based on functional observations while studies considering the underlying physiology are less common. However, understanding the underlying mechanisms that contribute to an improved range of motion through stretching is crucial for conducting comparable studies with sound designs, optimising training routines and accurately interpreting resulting outcomes. While there seems to be no evidence to attribute acute range of motion increases as well as changes in muscle and tendon stiffness and pain perception specifically to stretching or foam rolling, the role of general warm-up effects is discussed in this paper. Additionally, the role of mechanical tension applied to greater muscle lengths for range of motion improvement will be discussed. Thus, it is suggested that physical training stressors can be seen as external stimuli that control gene expression via the targeted stimulation of transcription factors, leading to structural adaptations due to enhanced protein synthesis. Hence, the possible role of serial sarcomerogenesis in altering pain perception, reducing muscle stiffness and passive torque, or changes in the optimal joint angle for force development is considered as well as alternative interventions with a potential impact on anabolic pathways. As there are limited possibilities to directly measure serial sarcomere number, longitudinal muscle hypertrophy remains without direct evidence. The available literature does not demonstrate the necessity of only using specific flexibility training routines such as stretching to enhance acute or chronic range of motion.

The Acute Effect of Percussive Massage Intervention with and without Heat Application on Plantar Flexor Muscles' Passive and Active Properties

Recently, percussive massage (PM) intervention using a handheld percussive massage device, namely a massage gun, has been used as an easy way to perform vibration functions. Additionally, a product has been developed that allows PM intervention and heat application to be performed simultaneously. Thus, this study aimed to compare the acute effects of PM intervention with and without heat application on dorsiflexion (DF) range of motion (ROM), passive stiffness, and muscle strength in the gastrocnemius muscle. Fifteen healthy young men (20.9 ± 0.2 years) participated in this study. We measured the DF ROM, passive torque at DF ROM (an indicator of stretch tolerance), passive stiffness, and maximum voluntary isometric contraction (MVIC) torque of the plantar flexor muscles before and immediately after 120 seconds PM intervention with and without heat application. The results showed that PM intervention with and without heat application significantly increased DF ROM and passive torque at DF ROM and decreased passive stiffness, not MVIC torque. These results suggest that PM intervention increased ROM and decreased passive stiffness regardless of the presence or absence of the heat application.

The non-local effects of 7-week foot sole static stretching and foam rolling training on shoulder extension range of motion

Static stretching and foam rolling can increase the range of motion (ROM) of a joint acutely as well as chronically. Although studies have reported ROM increases of a non-stretched heterologous muscle (non-local) following an acute static stretching or foam rolling session, these effects have not been studied for long-term training interventions. Therefore, the purpose of this study was to investigate the effects of a comprehensive 7-week static stretching and foam rolling training program of the foot sole on shoulder extension ROM. A total of 33 healthy, physically active participants (20 male) were assigned to either the intervention (n = 19) or control (n = 14) group. The intervention group performed a 7-week combined static stretching and foam rolling intervention comprising three sessions a week, including three exercises of the foot sole for 5 min each. Before and after the intervention period, the shoulder extension ROM was tested with three-dimensional (3D) motion caption. The level of significance for all statistical analyses was set to ρ ≤ 0.05. There was no significant time (p = 0.70, F1, 31 = 0.157; η2 = 0.005) or time×group effect (p = 0.38, F1, 31 = 0.785; η2 = 0.025) in shoulder extension ROM, indicating no ROM changes in the intervention or the control group. Although previous studies on the acute effects of stretching and foam rolling reported non-local increases in ROM in heterologous muscles, this study could show that such effects do not occur after chronic SS and foam rolling training for 7 weeks. Consequently, if the goal is to chronically increase the ROM of a specific joint, it is recommended to directly treat the muscles of interest.

Remote effects of a 7-week combined stretching and foam rolling training intervention of the plantar foot sole on the function and structure of the triceps surae

It is known that a single bout of foam rolling (FR) or stretching can induce changes in range of motion (ROM) and performance in non-directly adjoining areas of the dorsal chain (i.e., remote effects). However, to date, it is not known if such effects exist following long-term interventions. Thus, the purpose of this study was to investigate the remote effects of a 7-week combined stretching and FR training intervention of the plantar foot sole. Thirty-eight recreational athletes were randomly assigned to either an intervention (n = 20) or control (n = 18) group. The intervention group performed stretching and FR exercises of the plantar foot sole for 7 weeks. Before and after the intervention, the dorsiflexion ankle ROM, passive resistive torque at maximum angle (PRTmax) and at a fixed angle, as well as maximum voluntary isometric contraction (MVIC) torque, were measured with a dynamometer. Gastrocnemius medialis and lateralis stiffness was assessed with shear wave elastography. The results showed no interaction effect for any of the parameters. There was a time effect indicating an increase in MVIC and PRTmax, which was more pronounced in the intervention group (+ 7.4 (95% CI 2.5-12.4),  + 4.5 (95% CI - 0.2-9.2)) than the control group (+ 3.6 (95% CI - 1.4-8.6),  + 4.0 (95% CI - 2.2 to 10.2)). The results indicate no or minor remote effects of combined stretching and FR of the foot sole in the ankle joint. Potential non-significant changes in ROM were accompanied with an increase in stretch tolerance, but not with changes in muscle structure.

The contralateral effects of foam rolling on range of motion and muscle performance

A single bout of foam rolling (FR) can acutely increase joint range of motion (ROM) without detrimental effects on subsequent muscle performance. Similarly, long-term FR training can increase ROM, while muscle performance seems to be unaffected. Although the acute and long-term effects of FR on the treated muscle are understood, the impact of FR on the contralateral side is not well known. Therefore, this scoping review aims to summarize the current evidence on the acute and long-term effect of FR on the ipsilateral limb on ROM and muscle performance (i.e., maximum force, rate of force development, jump height) for the contralateral (non-treated) limb. Potential explanatory mechanisms are also discussed. There is evidence that a single bout of FR on the ipsilateral limb increases ROM of the contralateral limb; however, evidence is limited for long-term effects. The most likely mechanism for contralateral ROM increases is a reduced perception of pain. With regard to isolated muscle contractions, no changes in muscle performance (i.e., maximum voluntary isometric contraction, maximum voluntary dynamic contraction) were found in the contralateral limb after a single bout of FR on the ipsilateral limb. Notably, only one study reported large impairments in rate of force development of the contralateral limb following FR on the ipsilateral leg, possibly due to decreased motor unit recruitment. Furthermore, to date there are only two studies examining the long-term FR training of the ipsilateral limb on performance (i.e., maximal strength and jump performance) which reported moderate improvements. Although, trivial to very large changes on a variety of parameters were found in this study, the functional and practical relevance of our findings should be interpreted with caution.

A 1-Week Comprehensive Foam Rolling Intervention Program Can Improve Knee Pain but Not Muscle Function and Range of Motion in Patients with Total Knee Arthroplasty

We investigate the effect of a 1-week comprehensive foam rolling (FR) intervention program on knee pain, range of motion (ROM), and muscle function in patients with TKA.Thirty patients with TKA were randomly allocated to FR (n = 15) or control (n = 15) groups. The control group received only regular physical therapy. Patients in the FR group performed the FR intervention in addition to their regular physical therapy twice daily from postoperative weeks two to three (60 s × 3 repetitions × 2 times/day × 6 days: total = 2160 s). Pain score, knee flexion and extension ROM, muscle strength, walking function, and balance function were measured before and after the FR intervention. From the second to third postoperative weeks, there were significant improvements in all variables, and the reduction in pain score at stretching was significantly greater in the FR group (-26.0 ± 1.4; p < 0.05) than in the control group (-12.5 ± 1.9). However, there was no significant difference in changes in the other variables except for the pain score at stretching between FR and control groups. A 1-week comprehensive FR intervention program in patients with TKA could reduce pain scores at stretching without a synergistic effect on physical function, i.e., walking speed, balance function, and muscle strength of the knee extensors muscles.

Self-Myofascial Release of the Foot Plantar Surface: The Effects of a Single Exercise Session on the Posterior Muscular Chain Flexibility after One Hour

This study evaluated the effects of a single exercise session of Self-Myofascial Release (SMR) on the posterior muscular chain flexibility after one hour from the intervention. Thirty-six participants performed SMR using a rigid ball under the surface of both feet. Participants were tested with the Sit and Reach (S&R) test at four different times: before (T0), immediately after (T1), 30 (T2), and 60 (T3) minutes after the SMR intervention. The sample (n = 36) was categorized into three groups: (1) flexible, (2) average, and (3) stiff, based on the flexibility level at T0 (S&R values of >10 cm, >0 but <10 cm and <0 cm, respectively). For the whole sample, we detected significant improvements in the S&R test between the T1, T2, and T3 compared to T0. The stiff group showed a significant (p < 0.05) improvement between T1−T2 and T1−T3. Results were similar between the average group and the whole sample. The flexible group did not show any significant difference (p > 0.05) over time. In conclusion, this investigation demonstrated that an SMR session of both feet was able to increase posterior muscular chain flexibility up to one hour after intervention. Considering that a standard training session generally lasts one hour, our study can help professionals take advantage of SMR effects for the entire training period. Furthermore, our results also demonstrate that physical exercise practitioners should also assess individuals’ flexibility before training, as the SMR procedure used in this work does not seem necessary in flexible individuals.

Comparison of the Prolonged Effects of Foam Rolling and Vibration Foam Rolling Interventions on Passive Properties of Knee Extensors

Foam rolling (FR) and vibration foam rolling (VFR) interventions have received attention as pre-exercise warm-ups because they maintain performance and increase range of motion (ROM). However, the immediate and prolonged effects and the comparisons between FR and VFR interventions are unknown. Therefore, this study was designed to compare the effects of FR and VFR interventions on passive properties of knee extensors over time (up to 30 min after interventions). A crossover, random allocation design was used with 14 male college students (22.1 ± 1.0 years old) in the control, FR, and VFR conditions. The knee flexion ROM, pain pressure threshold (PPT), and tissue hardness were measured before and immediately after, 10, 20, and 30 minutes after the intervention. The results showed that knee flexion ROM increased significantly immediately after the intervention in both the FR and VFR conditions and maintained up to 30 minutes after both conditions. PPT increased significantly (p < 0.01) immediately after the FR intervention. In the VFR condition, there was a significant increase in PPT immediately after the intervention (p < 0.01) and 10 minutes after the intervention (p < 0.05). Tissue hardness was significantly decreased (p < 0.01) immediately after and 10 minutes after the FR intervention. However, tissue hardness in the VFR condition was significantly decreased (p < 0.01) up to 30 minutes after the intervention. The results suggest that FR and VFR interventions increase knee flexion ROM, and the effect lasts at least 30 minutes, but the effects on PPT and tissue hardness are maintained a longer time in the VFR condition compared to the FR condition. Therefore, VFR can be recommended as a warm-up before exercise to change the passive properties of knee extensors.

The Effects of Foam Rolling Training on Performance Parameters: A Systematic Review and Meta-Analysis including Controlled and Randomized Controlled Trials

Foam rolling (FR) is a new and popular technique for increasing range of motion. While there are a few studies that demonstrate increased performance measures after an acute bout of FR, the overall evidence indicates trivial performance benefits. As there have been no meta-analyses on the effects of chronic FR on performance, the objective of this systematic meta-analytical review was to quantify the effects of FR training on performance. We searched PubMed, Scopus, the Cochrane library, and Web of Science for FR training studies with a duration greater than two weeks, and found eight relevant studies. We used a random effect meta-analysis that employed a mixed-effect model to identify subgroup analyses. GRADE analysis was used to gauge the quality of the evidence obtained from this meta-analysis. Egger's regression intercept test (intercept 1.79; p = 0.62) and an average PEDro score of 6.25 (±0.89) indicated no or low risk of reporting bias, respectively. GRADE analysis indicated that we can be moderately confident in the effect estimates. The meta-analysis found no significant difference between FR and control conditions (ES = -0.294; p = 0.281; I² = 73.68). Analyses of the moderating variables showed no significant differences between randomized control vs. controlled trials (Q = 0.183; p = 0.67) and no relationship between ages (R² = 0.10; p = 0.37), weeks of intervention (R² = 0.17; p = 0.35), and total load of FR (R² = 0.24; p = 0.11). In conclusion, there were no significant performance changes with FR training and no specific circumstances leading to performance changes following FR training exceeding two weeks.

Comparison of The Effect of High- and Low-Frequency Vibration Foam Rolling on The Quadriceps Muscle

Vibration foam rolling (VFR) intervention has recently gained attention in sports and rehabilitation settings since the superimposed vibration with foam rolling can affect several physiological systems. However, the sustained effect and a comparison of the effects of different VFR vibration frequencies on flexibility and muscle strength have not been examined. Therefore, in this study, we aimed to investigate the acute and sustained effects of three 60-s sets of VFR with different frequencies on knee flexion range of motion (ROM) and muscle strength of the knee extensors. Using a crossover, random allocation design, 16 male university students (21.2 ± 0.6 years) performed under two conditions: VFR with low (35 Hz) and high (67 Hz) frequencies. The acute and sustained effects (20 min after intervention) of VFR on knee flexion ROM, maximum voluntary isometric contraction (MVC-ISO) torque, maximum voluntary concentric contraction (MVC-CON) torque, rate of force development (RFD), and single-leg countermovement jump (CMJ) height were examined. Our results showed that knee flexion ROM increased significantly (p &lt; 0.01) immediately after the VFR intervention and remained elevated up to 20 min, regardless of the vibration frequency. MVC-ISO and MVC-CON torque both decreased significantly (p &lt; 0.01) immediately after the VFR intervention and remained significantly lowered up to 20 min, regardless of the vibration frequency. However, there were no significant changes in RFD or CMJ height. Our results suggest that VFR can increase knee flexion ROM but induces a decrease in muscle strength up to 20 min after VFR at both high and low frequencies.