Psychophysiological effects of massage-myofascial release after exercise: a randomized sham-control study

Myofascial induction technique changes plantar pressures variables compared to a simulated laser. A randomized clinical trial

BACKGROUND

The fascial system is made up of large number of mechanoreceptors and cells that regulate their tension, such as myofibroblasts, in addition to an extracellular matrix. The treatment of myofascial induction has shown in the static imprint in a quasi-experimental study comparing the effect before and after the technique, but there are no studies compared with a control with no real intervention. The objective of this research is to check the effects of the myofascial Induction technique, compared with a simulated Laser in plantar footprint variables in asymptomatic subjects.

METHODS

Thirty-six healthy participants were recruited to carry out a single-blind clinical study in randomizated two groups. Experimental intervention group performed a bilateral plantar fascia of Myofascial Induction technique. Control intervention group performed a simulated Laser. The time of application of the techniques were 5 min for both interventions. The variables recorded were Surface, mean pressure and maximum pressure for each region of the foot, rear foot, midfoot and fore foot.

RESULTS

Both groups were homogeneous prior to the interventions. The significant differences found later were in the forefoot surface variable (p = 0.026) where there was an increase in the area in the experimental group.

CONCLUSIONS

The myofascial induction technique shows effects on the static plantar footprint by increasing the surface of the forefoot compared to the application of a simulated laser. Registration in ClinicalTrial.gov (ID: NCT04628299) Registered in clinicalTrials.govhttps://clinicaltrials.gov/ct2/show/NCT04628299.

Vibration Foam Rolling Treatment Influence on Acute Changes in Plantar Flexors Muscle Temperature and Surface Emg Activity in Amateur Male Athletes

Background/Objectives: Foam rolling is widespread and deeply rooted in exercise practice. The optimal duration and role of this treatment still lack scientific consensus. A relatively novel foam rolling treatment that combines vibration during application targets different muscle characteristics that are not well understood. Studies exploring this combined treatment are scarce. The aim of this study was set to investigate the acute effects of different duration vibration (15 s, 30 s, and 60 s) foam rolling treatment (VFRt) on muscle skin temperature and surface muscle electromyography (sEMG) during Maximal Voluntary Isometric Contraction. Methods: Eighteen male subjects performed four sets of three trials of maximal isometric heel rises during three experimental sessions conducted in research laboratory. Results: Repeated measures of ANOVA determined that the muscle skin temperature significant difference was only found for the 30 s treatment (p = 0.013-0.000). For surface muscle electromyography a 30 s treatment out of all three yielded the most significant results, between pretreatment set and post-treatment set 1 (p = 0.01)-small effect size (Cohen's d = -0.33)-and pretreatment set to post-treatment set 3 (p = 0.01)-small effect size (Cohen's d = -0.30). Conclusions: All treatments did not produce significant differences during Maximal Voluntary Isometric Contraction heel rises, which-for practical application purposes-present a safe treatment. Future studies should investigate the acute effects of longer duration treatment on changes in surface muscle temperature. In terms of practical application, other findings suggest that muscle efficiency was improved taken into account of unchanged muscle strength along with decreased sEMG, which is beneficial. Also, the downward trend of muscle activity caused by the other two treatment durations could be of significance for practical application during rehabilitation process or during activities where this is a desired and indicated goal. In terms of targeting elevated muscle activity, 30 s of VFRt is the treatment of choice.

Myofascial release induces declines in heart rate and changes to microvascular reactivity in young healthy adults

OBJECTIVES

The purpose of this study was to compare physiological responses to myofascial release (MFR) and passive limb movement (PLM).

DESIGN

Nineteen (23 ± 2.6yrs) adults (10 men and 9 women) completed two experiments on separate days: MFR and PLM. Participation included collecting ultrasound images, blood pressure, and heart rate (HR) as well as performing a vascular occlusion test (VOT). The VOT assessed muscle tissue oxygenation (StO2) with near-infrared spectroscopy. Experiments consisted of moving the upper limb to release subtle barriers of resistance in the muscle/fascia (MFR) and passive, assisted range of motion (PLM).

RESULTS

There was a significantly (p = 0.012) greater decrease in HR following MFR (-7.3 ± 5.2 BPM) than PLM (-1.3 ± 0.9 BPM). There was an equivalent change in brachial blood flow (-17.3 ± 23.0 vs. -11.9 ± 14.9 mL min-1; p = 0.37) and vascular conductance (-19.3 ± 31.1 vs. -12.4 ± 15.3 mL min-1 mmHg-1; p = 0.38). Microvascular responses differed between the experiments such that MFR exhibited greater area under the curve (AUC, 1503 ± 499.1%∙s-1 vs. 1203 ± 411.1%∙s-1; p = 0.021) and time to maximum StO2 (40.0 ± 8.4s vs. 35.8 ± 7.3s; p = 0.009).

CONCLUSIONS

As evidenced by HR, MFR induced greater parasympathetic activity than PLM. The greater AUC and time to StO2max following MFR suggested a spillover effect to induce prolonged hyper-saturation. These results may be of interest to those investigating possible MFR-related rehabilitative benefits.

Does the Self-Myofascial Release Affect the Activity of Selected Lower Limb Muscles of Soccer Players?

Myofascial therapy has already become one of the basic forms of treatment of the locomotor system. One form of the therapy is Self-Myofascial Release, in which external force is applied to the body with the help of special rollers (foam rolling, FR). The aim of the study was to investigate the direct effect of Self-Myofascial Release of hamstring muscles using a foam roller on the bioelectric activity of selected muscles (biceps femoris and gluteus maximus) during squats. The study involved 40 male soccer players, who were randomly divided into two groups: experimental and control. The tests used did not show significant differences in the analyzed variables before the experiment (baseline measurement p > 0.05), while significant intergroup differences appeared for subsequent measurements, both for reference MVC values (p < 0.01 - for % gluteus maximus MVC, p < 0.001 - for % biceps femoris MVC) and for raw EMG values (p < 0.01 gluteus maximus and p < 0.001 - for % 0.0001 for biceps femoris). The use of self-myofascial release within the hamstring muscles leads to changes in the electrical potential of the muscles of the lower limb.

Acute Effects of Foam Rolling on Hamstrings After Half-Marathon: A Muscle Functional Magnetic Resonance Imaging Study

Purpose: Foam rolling (FR) is widely used for post-exercise muscle recovery; yet, the effects of FR on skeletal muscle inflammation and microvascular perfusion following prolonged exercise are poorly understood. We aim to address the gap in knowledge by using magnetic resonance imaging (MRI) T2 mapping and intravoxel incoherent motion (IVIM) sequences to study the acute effects of FR on hamstrings following half-marathon running in recreational runners.

Methods: Sixteen healthy recreational marathon runners were recruited. After half-marathon running, FR was performed on the hamstrings on the dominant side, while the other limb served as a control. MRI T2 and IVIM scans were performed bilaterally at baseline (pre-run), 2–3 h after running (post-run), immediately after FR (post-FR0), 30 min after FR (post-FR30) and 60 min after FR (post-FR60). T2, a marker for inflammatory edema, as well as IVIM microvascular perfusion fraction index f for biceps femoris long head (BFL), semitendinosus (ST) and semimembranosus (SM) were determined. Total Quality Recovery (TQR) scale score was also collected.

Results: Both T2 and f were higher at post-run compared to pre-run in all hamstrings on both sides (all p < 0.05; all d > 1.0). For the FR side, T2 decreased, and f increased significantly at post-FR0 and post-FR30 compared to post-run in all muscles (p < 0.05; all d > 0.4) except for f at BFL and SM at post-FR30 (both p > 0.05), though f at BFL was still marginally elevated at post-FR30 (p = 0.074, d = 0.91). Both parameters for all muscles returned to post-run level at post-FR60 (all p > 0.05; all d < 0.4) except for T2 at SM (p = 0.037). In contrast, most MRI parameters were not changed at post-FR0, post-FR30 and post-FR60 compared to post-run for the control side (p < 0.05; d < 0.2). TQR scores were elevated at post-FR0 and post-FR30 compared to post-run (both p < 0.05; both d > 1.0), and returned to the post-run level at post-FR60 (p > 0.99; d = 0.09). Changes in TQR scores compared to post-run at any time points after FR were correlated to T2 for ST at post-FR30 (r = 0.50, p = 0.047) but not T2 for other muscles and any changes in f values.

Conclusions: Hamstrings inflammatory edema and microvascular perfusion were elevated following half-marathon running, which were detectable with MRI T2 mapping and IVIM sequences. FR resulted in acute alleviation in inflammation and greater microvascular perfusion; however, the effects seemed to last only for a short period of time (30–60 min). FR can provide short-term benefits to skeletal muscle after prolonged running.

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.

Almond oil: A comprehensive review of chemical composition, extraction methods, preservation conditions, potential health benefits, and safety

Almond oil, a rich source of macronutrients and micronutrients, is extracted for food flavorings and the cosmetics industry. In recent years, the need for high-quality and high-quantity production of almond oil for human consumption has been increased. The present review examines the chemical composition of almond oil, storage conditions, and clinical evidence supporting the health benefits of almond oil. From the reviewed studies, it appears that almond oil contains a significant proportion of poly and monounsaturated fatty acids, with oleic acid as the main compound, and an important amount of tocopherol and phytosterol content. Some variations in almond oil composition can be found depending on the kernel's origin and the extraction system used. Some new technologies such as ultrasonic-assisted extraction, supercritical fluid extraction, subcritical fluid extraction, and salt-assisted aqueous extraction have emerged as the most promising extraction techniques that allow eco-friendly and effective recovery of almond oil. This safe oil was reported by several clinical studies to have potential roles in cardiovascular risk management, glucose homeostasis, oxidative stress reduction, neuroprotection, and many dermatologic and cosmetic applications. However, the anticarcinogenic and fertility benefits of almond oil have yet to be experimentally verified.

Effect of Varying Self-myofascial Release Duration on Subsequent Athletic Performance

ABSTRACT

Phillips, J, Diggin, D, King, DL, and Sforzo, GA. Effect of varying self-myofascial release duration on subsequent athletic performance. J Strength Cond Res 35(3): 746-753, 2021-Self-myofascial release (SMR) treatments can enhance joint range-of-motion and restore movement function. The effects of different SMR durations on athletic performance have yet to be examined. Twenty-four volunteers had ankle and knee joint range-of-motion assessed using modified weight-bearing and kneeling lunge (KL) tests. Vertical jump and pro-agility sprint performance were also examined. All tests were conducted before and immediately after 1 (SMR_1) and 5 minutes (SMR_5) of foam rolling, and immediately after a control (CONTR) condition. Results showed KL scores increased after SMR_5 (16.4%; effect size [ES] = 0.85) when compared with SMR_1 (12.5%; ES = 0.58). Weight-bearing lunge scores showed little change after either SMR treatment. The CONTR condition exhibited little effect on joint range-of-motion. Vertical jump performance decreased after SMR_5 (5.1%; ES = 0.26) but changed little after SMR_1 (0.7%; ES = 0.03) and CONTR (1.9%; ES = 0.10) conditions. Pro-agility performance improved slightly after SMR_1 (1.1%) but deteriorated after CONTR (1.2%) and SMR_5 (0.5%). Effect size calculations for changes in pro-agility sprint times were trivial across all conditions (0.06-0.15). Data suggest that extended periods of SMR may be recommended, should improvements in joint range-of-motion be required. If power output is a critical requirement of subsequent exercise/performance tasks, prolonged SMR treatment (i.e., 5 minutes) should be avoided. Practitioners should be cautious when implementing SMR treatments within warm-ups.

Comparison of the Immediate Effect of Petrissage Massage and Manual Lymph Drainage Following Exercise on Biomechanical and Viscoelastic Properties of the Rectus Femoris Muscle in Women

CONTEXT

Fast and adequate recovery after exercise and activity is important for increasing performance and preventing injuries. Inadequate recovery usually causes changes in the biomechanical and viscoelastic properties of the muscle.

OBJECTIVE

To compare the immediate effect of petrissage massage (PM) and manual lymph drainage (MLD) following submaximal exercise on the biomechanical and viscoelastic properties of the rectus femoris muscle in healthy women.

DESIGN

Cross-sectional, repeated-measures.

SETTING

Marmara University.

PARTICIPANTS

18 healthy female students.

INTERVENTION(S)

Following the submaximal quadriceps strengthening exercise performed in 3 sets of 8 repetitions with intensity of 75% of 1 maximum repetition, participants' right leg received a 5-minute PM (PM group) and the contralateral leg received a 5-minute MLD application (MLD group).

MAIN OUTCOME MEASURES

Skin temperature was measured using P45 thermographic thermal camera (Flir System; ThermaCAM, Danderyd, Sweden), and muscle tone, biomechanical, and viscoelastic features were measured with a myometer (Myoton AS, Tallinn, Estonia) at baseline, immediately postexercise, post-PM/MLD application, and 10 minutes postexercise.

RESULTS

In the PM group, the tonus (P = .002) and stiffness (P < .001) values measured after the massage and at the end of the 10-minute resting period were found to be statistically different than those measured right after the exercise (P < .05). Relaxation time and creep values at all measurement times were significantly different (P < .05). In the MLD group, it was observed the tonus (P < .001), stiffness (P = .025), and relaxation time (P < .01) values decreased significantly after the MLD compared with the values measured after the exercise; however, the creep value was found to be significantly different in all measurements (P < .05).

CONCLUSION

PM and MLD reduce passive tissue stiffness and improve the extent of muscle extensibility over time against the muscle tensile strength. PM and MLD are therapeutic methods that can be used to support tissue recovery after exercise and prevent injuries.

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

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

Effect of sports massage on performance and recovery: a systematic review and meta-analysis

Objective

Massage is ubiquitous in elite sport and increasingly common at amateur level but the evidence base for this intervention has not been reviewed systematically. We therefore performed a systematic review and meta-analysis examining the effect of massage on measures of sporting performance and recovery.

Design and eligibility

We searched PubMed, MEDLINE and Cochrane to identify randomised studies that tested the effect of manual massage on measures of sporting performance and/or recovery. We performed separate meta-analyses on the endpoints of; strength, jump, sprint, endurance, flexibility, fatigue and delayed onset muscle soreness (DOMS).

Results

We identified 29 eligible studies recruiting 1012 participants, representing the largest examination of the effects of massage. We found no evidence that massage improves measures of strength, jump, sprint, endurance or fatigue, but massage was associated with small but statistically significant improvements in flexibility and DOMS.

Conclusion

Although our study finds no evidence that sports massage improves performance directly, it may somewhat improve flexibility and DOMS. Our findings help guide the coach and athlete about the benefits of massage and inform decisions about incorporating this into training and competition.

Effects of a Single Myofascial Induction Session on Neural Mechanosensitivity in Breast Cancer Survivors: A Secondary Analysis of a Crossover Study

OBJECTIVES

The purpose of this study was to investigate the short-term effects of myofascial induction on mechanosensitivity of upper limb nerves.

METHODS

In this secondary analysis of a randomized, single-blind, placebo-controlled crossover study, 21 breast cancer survivors with stage I-IIIA cancer were randomly allocated to an experimental group (30 minutes of myofascial induction session) or placebo control group (unplugged pulsed 30 minutes of shortwave therapy), with a 4-week washout period between sessions that occurred in a physical therapy laboratory in the Health Science Faculty (University of Granada, Spain). Range of motion (universal goniometry), structural differentiation, symptoms (yes/no), and pressure pain thresholds (electronic algometry) were assessed during neurodynamic tests and attitude toward massage scale as covariate.

RESULTS

An analysis of covariance revealed significant time × group interactions for range of motion in affected upper limb nerves (median, P < .001; radial, P = .036; ulnar, P = .002), but not for nonaffected upper limb nerves (median, P = .083; radial, P = .072; ulnar, P = .796). A χ2 or Fisher exact test, as appropriate, also revealed a significant difference (P = .044) in sensitivity for the affected upper limb ulnar nerve in the experimental group, whereas the rest of the assessed nerves (affected and nonaffected upper limb nerves) showed no significant changes in either the experimental or control groups (P > .05). An analysis of covariance revealed no significant interactions on pressure pain thresholds over the nerves for affected (all P > .05) and nonaffected (all P > .05) upper limb nerves.

CONCLUSION

A single myofascial induction session may partially improve mechanosensitivity of median, radial, and ulnar nerves and yield positive effects on symptom mechanosensitivity, especially regarding the ulnar nerve in breast cancer survivors.

Pressure and Traction Technique Improves Postural Control More Than Tactile Stimulation in Foot Plantar Fascia: A Randomized Single-Blind Trial

OBJECTIVE

To check the acute effects of manual pressure and traction technique on balance and plantar footprint variables.

DESIGN

A single-blind clinical study with 2 groups.

SETTING

Private practice.

PARTICIPANTS

Healthy participants (N=40; 28 female and 12 male) were recruited to carry out a single-blind study.

INTERVENTIONS

Experimental group performed a bilateral plantar fascia manual pressure and traction technique. Control group performed a tactile stimulation. The position of the participant, the therapist, and the time of application of the techniques (5min) were the same for both interventions.

MAIN OUTCOME MEASURES

We measured stabilometry variables and static footprint. The footprint variables were divided in rear, middle, and front foot areas.

RESULTS

Significant differences were found in stabilometry variables. There was an improvement in experimental group at X displacement with eyes open (P=.014) and surface eyes closed (P=.046) variables.

CONCLUSIONS

After technique the experimental group improved the stabilometry variables, specifically surface with eyes closed and X displacement with eyes open. The static footprint variables have not shown differences after the technique compared with the control group.

Massage therapy slightly decreased pain intensity after habitual running, but had no effect on fatigue, mood or physical performance: a randomised trial

QUESTION

Does massage therapy reduce pain and perceived fatigue in the quadriceps, and improve the mood and physical performance of runners after habitual sporting activity (10-km run)?

DESIGN

Randomised controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment.

PARTICIPANTS

Seventy-eight runners after sporting activity (10-km run).

INTERVENTION

The experimental group received 10 minutes of massage to the quadriceps aimed at recovery following sport practice, and the control group received a sham joint mobilisation.

OUTCOME MEASURES

Pain and perceived fatigue were each assessed using a 0-to-10 numerical rating scale; pain behaviour via the McGill Pain Questionnaire; mood profile via Brunel Mood Scale; quadriceps muscle flexibility using maximal knee flexion angle via inclinometer; isometric muscle strength of knee extensors via hand-held dynamometry; and vertical jump performance using jump height via My Jump 2 app. Evaluations were carried out immediately before and after the intervention, and at 24, 48 and 72 hours after the intervention. Generalised estimating equations were used to estimate a between-group difference (95% CI) using data across all time points.

RESULTS

The experimental group had significantly lower scores than the control group on the numerical rating scale for pain by 0.7 points (95% CI 0.1 to 1.3). There were no significant between-group differences for any of the other outcome measures.

CONCLUSION

Massage therapy was effective at reducing pain intensity after application to the quadriceps of runners compared to a sham technique, but the magnitude of the effect was small. There were no significant effects on perceived fatigue, flexibility, strength or jump performance.

TRIAL REGISTRATION

Brazilian Registry of Clinical Trials, RBR-393m7m.

Effectiveness of myofascial release after breast cancer surgery in women undergoing conservative surgery and radiotherapy: a randomized controlled trial

PURPOSE

The scars derived from the treatment of breast cancer lead to adverse effects such as fibrosis or retractions of the connective tissue. Myofascial release (MR) seeks to reduce restrictions of the fascial system. Therefore, the aim of this study was to analyze the clinical impact of MR treatment on women survivors of breast cancer.

METHODS

We enrolled 24 women with breast cancer, 13 received myofascial release treatment (MR) and 11, a placebo manual lymphatic drainage treatment (PMLD). Both interventions were administered over a period of 4 weeks. The outcomes studied were pain, shoulder range of motion (ROM), functionality, quality of life (QoL), and depression, immediately after treatment and 1 month later.

RESULTS

After 4 weeks of treatment, only the participants who received MR experienced a significant decrease in pain intensity in the short and midterm (p < 0.05). This therapy also achieved a general improvement in ROM (p < 0.05), except for internal rotation, that persisted 1 month after treatment. Regarding functionality, both therapies achieved the level of significance (p < 0.05), but only MRG sustained the improvement in the midterm. General QoL, assessed with FACT-B, and its physical well-being dimension were significantly improved after MR implementation (p < 0.05), while the emotional dimension and the breast cancer subscale improved only with PMLD (p < 0.05).

CONCLUSIONS

In conclusion, an MR-based treatment shows physical benefits (i.e., overall shoulder movement, functionality, and perceived pain) in women after breast cancer surgery.

TRIAL REGISTRATION

This study is registered on ClinicalTrials.gov NCT03182881.

Effects of Self-Myofascial Release on Shoulder Function and Perception in Adolescent Tennis Players

CONTEXT

Tennis induces a decreased internal rotation range of motion at the dominant glenohumeral joint. The effects of self-myofascial release have not yet been investigated to restore glenohumeral range of motion.

OBJECTIVE

This study aimed at investigating the effects of self-myofascial release on shoulder function and perception in adolescent tennis players.

DESIGN

Test-retest design.

SETTING

Tennis training sport facilities.

PARTICIPANTS

Eleven male players participated in this study (age: 15 [3] y; height: 173.1 [11.1] cm; mass: 56.0 [15.1] kg; International Tennis Number: 3).

INTERVENTION

During 5 weeks, the players performed their regular tennis training. During 5 additional weeks, self-myofascial release of the infraspinatus and pectoralis muscles was implemented 3 times per week after the warm-up of the regular training session.

MAIN OUTCOME MEASURES

The primary outcome was glenohumeral internal rotation range of motion. The secondary outcomes were perceived shoulder instability and tennis serve accuracy and velocity.

RESULTS

Adding self-myofascial release allowed an increase of 11° (2°) of internal rotation range of motion at the dominant glenohumeral joint (P < .001) and a decreased perception of shoulder instability (P = .03), while maintaining tennis serve velocity and accuracy.

CONCLUSIONS

Implementing self-myofascial release on infraspinatus and pectoralis muscles 3 times per week during 5 weeks improved dominant glenohumeral internal rotation range of motion in tennis players. It can be used as a strategy to preserve the mobility of this joint.

The Acute Effects of Foam Rolling on Fatigue-Related Impairments of Muscular Performance

The purpose of this study was to examine the effects of self-myofascial release (MFR) via foam rolling immediately following strenuous activity on acute fatigue-related impairments of muscular performance. Healthy male (n = 16) and female (n = 9) subjects visited the laboratory three separate times. During visit 1, subjects were familiarized with performance testing procedures and the foam rolling and fatigue protocols. For visits 2 and 3, subjects were (T1) assessed for vertical jump height, velocity, and power and dynamic reaction time (DRT). Subjects then performed the exercise fatigue protocol, followed by either a foam rolling treatment (MFR) or seated rest (CON). Immediately after, subjects repeated the performance tests (T2). CON resulted in a greater percent decline from T1–T2 for average power (p = 0.03), average velocity (p = 0.02), and peak power (p = 0.03) than the MFR treatment. No between-treatment differences were detected for %∆ vertical jump height (p = 0.14) or DRT (p = 0.20). According to magnitude-based inference analysis, MFR is likely beneficial in attenuating fatigue-induced kinematic decrements (i.e., power and velocity). Based on magnitude-based inference analysis, MFR is “possibly beneficial” with respect to mitigating acute fatigue-related impairment of jump height and dynamic reaction time. Results demonstrate the plausible short-term benefits of foam rolling on muscular performance decrements associated with acute muscular fatigue from exercise.

The effect of a single massage based on the tensegrity principle on postural stability in young women

OBJECTIVE

The aim of this study was to investigate the effects of normalized muscle tension via tensegrity-based massage on postural stability in a sample of female young adults.

METHODS

Nineteen females aged 21.8 ± 1.9 years were recruited presenting abnormal tension at muscles adhering to any of the following structural sites: superior iliac spine, lateral sacropelvic surface, linea aspera at 1/2 of femur length, and superior nuchal line of the occiput. Balance and postural control were assessed during bipedal stance using a force platform in multiple conditions: hard surface or soft foam surface with the head in either a neutral posture or tilted backward. Baseline and 3-min and 15-min post-treatment measures were collected while barefoot and eyes closed. Main outcomes measures included center of pressure variability, range, radius, and velocity in the anteroposterior (AP) mediolateral (ML) dimensions.

RESULTS

In the solid surface with neutral head posture condition only AP COP measures decreased significantly (p< 0.05). In the soft surface condition, significant differences were observed in the AP and ML dimensions among most measures (p< 0.05).

CONCLUSIONS

A single application of tensegrity-based massage positively influenced postural control in young adult females, particularly in the AP direction.

Myofascial Induction Effects on Neck-Shoulder Pain in Breast Cancer Survivors: Randomized, Single-Blind, Placebo-Controlled Crossover Design

OBJECTIVES

To (1) investigate the immediate effects of myofascial induction (MI), with placebo electrotherapy as a control, on perceived pain, cervical/shoulder range of motion (ROM), and mood state in breast cancer survivors (BCSs) with shoulder/arm morbidity; and (2) examine the relationships between pain modifications and cervical/shoulder ROM on the side affected by breast cancer.

DESIGN

Randomized, single-blind, placebo-controlled crossover study.

SETTING

Physical therapy laboratory.

PARTICIPANTS

BCSs (N=21) who had a diagnosis of stage I-IIIA breast cancer and had completed adjuvant therapy (except hormonal treatment).

INTERVENTION

During each session, the BCSs received either an MI (fascial unwinding) intervention focused on the upper limb area following the Pilat approach or placebo pulsed shortwave therapy (control group). Each session lasted 30 minutes, and an adequate washout period of 4 weeks between sessions was established.

MAIN OUTCOME MEASURES

The visual analog scale (VAS) for pain and anxiety, shoulder-cervical goniometry for ROM, the Profile of Mood States for psychological distress, and the Attitudes Towards Massage Scale were used.

RESULTS

An analysis of covariance (ANCOVA) revealed significant time × group interactions for VAS affected arm (P=.031) but not for VAS cervical (P=.332), VAS nonaffected arm (P=.698), or VAS anxiety (P=.266). The ANCOVA also revealed significant interactions for affected shoulder flexion (P<.001), abduction (P<.001), external rotation (P=.004), and internal rotation (P=.001). Significant interactions for affected cervical rotation (P=.022) and affected cervical lateral flexion (P=.038) were also found. A significant negative correlation was found between changes in VAS affected arm and shoulder/arm internal rotation ROM (r=-.46; P=.03).

CONCLUSIONS

A single MI session decreases pain intensity and improves neck-shoulder ROM to a greater degree than placebo electrotherapy for BCSs experiencing pain.

Short-term effects of traditional Thai massage on electromyogram, muscle tension and pain among patients with upper back pain associated with myofascial trigger points

OBJECTIVE

To investigate effects of traditional Thai massage (TTM) on electromyographic (EMG) activity, muscle tension and pain intensity in patients with upper back pain associated with myofascial trigger points (MTrPs).

DESIGN

A single-blind, randomized clinical trial.

SETTING

The Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Thailand.

INTERVENTION

Fifty patients were randomly assigned to receive a 30-min session of either TTM or control (sham microwave diathermy).

OUTCOMES

Electromyogram (EMG), Muscle tension rating, and pain intensity rating

RESULTS

TTM were associated with significant decreases in EMG, muscle tension and pain intensity after the end of treatment session (p<0.05). For all outcomes, similar changes were not observed in the control group (p>0.05) except for muscle tension (p<0.05). In addition, there was a significantly greater reduction in all parameters for the TTM group when compared with the control group.

CONCLUSION

We therefore suggest that TTM can increase physical relaxation and reduce pain in patients with upper back pain associated with MTrPs.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02067325.

The Immediate Effects of Manual Massage of Forearm on Power-Grip Strength and Endurance in Healthy Young Men

OBJECTIVE

The purpose of this study was to examine the immediate effects of a single massage session on hand grip strength and endurance after isometric exercise in healthy young men under controlled conditions.

METHODS

A total of 44 healthy young men from a university population participated in the study. They were randomized to receive either massage or passive movement intervention. Hand grip endurance and hand grip strength in both groups were recorded using a Jamar hand grip dynamometer and a digital chronometer before and after the intervention. Statistical analysis was performed using the Wilcoxon, Mann-Whitney, and paired t test as well as independent t test.

RESULTS

Pre-and postmean hand grip endurance times for the massage group were 38.4 ± 12 and 46.5 ± 13 seconds (P < .001), and hand grip strength values were 43 ± 5.6 and 45.7 ± 5.3 kg (P = .077). Pre-and postmean hand grip endurance times for the passive movement group were 33 ± 12.3 and 31.9 ± 10.7 seconds (P = .513), and hand grip strength values were 42.8 ± 6 and 42.9 ± 5.6 kg (P = .854).

CONCLUSION

Immediately after 1 session of massage to the forearm and hand, the grip endurance improved in a group of healthy young men. However, passive movement of the upper limb for 1 session did not enhance grip performance.

Do Patient Profiles Influence the Effects of Massage? A Controlled Clinical Trial

Considerable scientific evidence has been published on the effectiveness of massage in different conditions, but it remains unclear whether this effectiveness is modulated by the profile of patients. The aim of this study was to compare the effects of a 21-min myofascial therapy protocol on stress responders and nonresponders stressed in the laboratory with a cold pressor test. Dependent variables included heart rate variability (HRV), blood pressure, and salivary markers such as flow rate, cortisol, immunoglobulin A (IgA), and α-amylase activity. A controlled, repeated measures, single-blind trial was conducted in 30 Caucasian students with a mean (SD) age of 20.70 (4.50) years. We found no significant between-group differences in descriptive characteristics or in any preintervention outcome measure. Analysis of covariance revealed significant increases in HRV index (F = 0.18, p = .01), salivary flow rate (F = 0.16, p = .02), and salivary IgA concentration (F = 4.36, p = .04) and significant decreases in the low-frequency domain (F = 0.18, p = .04) and LF-high-frequency ratio (F = 0.18, p = .01) in the stress responder group in comparison to the nonresponder group. In conclusion, a better response to massage was observed in stress responders than in nonresponders across various HRV parameters and salivary measures.

Can sonographic features be efficacy predictors of robotic massage treatment for masseter and temporal muscle in patients with temporomandibular disorder with myofascial pain?

OBJECTIVE

The aim of this study was to detect sonographic predictors for the efficacy of massage treatment of masseter and temporal muscle in temporomandibular disorders (TMDs) patients with myofascial pain.

METHODS

Thirty-seven TMD patients with myofascial pain (6 men and 31 women, a median age of 45 years) were enrolled. An oral rehabilitation robot massaged the patient's masseter and temporal muscles with a standard massage pressure of 10 N for 16 min. The standard treatment protocol was set five sessions every 2 weeks. The median total duration of treatment was 9.5 weeks. Efficacy of treatment was evaluated based on maximum mouth opening and visual analog scale scores of muscle pain and daily life impediments. The intramuscular echogenic bands and elasticity index ratios of the masseter muscles were evaluated on sonographic or sonoelastographic images obtained before treatment and after the third and last treatment sessions.

RESULTS

The sonographic features detected different changes after the third treatment session between the therapy-effective and therapy-ineffective groups: in the therapy-effective group, the frequency of visibility of the distinct echogenic bands increased, and the elasticity index ratio decreased.

CONCLUSION

Sonographic features after the third treatment session may be useful as predictors of therapeutic efficacy.

The effects of myofascial release with foam rolling on performance

In the last decade, self-myofascial release has become an increasingly common modality to supplement traditional methods of massage, so a masseuse is not necessary. However, there are limited clinical data demonstrating the efficacy or mechanism of this treatment on athletic performance. The purpose of this study was to determine whether the use of myofascial rollers before athletic tests can enhance performance. Twenty-six (13 men and 13 women) healthy college-aged individuals (21.56 ± 2.04 years, 23.97 ± 3.98 body mass index, 20.57 ± 12.21 percent body fat) were recruited. The study design was a randomized crossover design in which subject performed a series of planking exercises or foam rolling exercises and then performed a series of athletic performance tests (vertical jump height and power, isometric force, and agility). Fatigue, soreness, and exertion were also measured. A 2 × 2 (trial × gender) analysis of variance with repeated measures and appropriate post hoc was used to analyze the data. There were no significant differences between foam rolling and planking for all 4 of the athletic tests. However, there was a significant difference between genders on all the athletic tests (p ≤ 0.001). As expected, there were significant increases from pre to post exercise during both trials for fatigue, soreness, and exertion (p ≤ 0.01). Postexercise fatigue after foam rolling was significantly less than after the subjects performed planking (p ≤ 0.05). The reduced feeling of fatigue may allow participants to extend acute workout time and volume, which can lead to chronic performance enhancements. However, foam rolling had no effect on performance.

An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force

Foam rolling is thought to improve muscular function, performance, overuse, and joint range of motion (ROM); however, there is no empirical evidence demonstrating this. Thus, the objective of the study was to determine the effect of self-myofascial release (SMR) via foam roller application on knee extensor force and activation and knee joint ROM. Eleven healthy male (height 178.9 ± 3.5 cm, mass 86.3 ± 7.4 kg, age 22.3 ± 3.8 years) subjects who were physically active participated. Subjects' quadriceps maximum voluntary contraction force, evoked force and activation, and knee joint ROM were measured before, 2 minutes, and 10 minutes after 2 conditions: (a) 2, 1-minute trials of SMR of the quadriceps via a foam roller and (b) no SMR (Control). A 2-way analysis of variance (condition × time) with repeated measures was performed on all dependent variables recorded in the precondition and postcondition tests. There were no significant differences between conditions for any of the neuromuscular dependent variables. However, after foam rolling, subjects' ROM significantly (p < 0.001) increased by 10° and 8° at 2 and 10 minutes, respectively. There was a significant (p < 0.01) negative correlation between subjects' force and ROM before foam rolling, which no longer existed after foam rolling. In conclusion, an acute bout of SMR of the quadriceps was an effective treatment to acutely enhance knee joint ROM without a concomitant deficit in muscle performance.

Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Muscle-biased therapies (MBT) are commonly used to treat pain, yet several reviews suggest evidence for the clinical effectiveness of these therapies is lacking. Inadequate treatment parameters have been suggested to account for inconsistent effects across studies. Pain sensitivity may serve as an intermediate physiologic endpoint helping to establish optimal MBT treatment parameters. The purpose of this review was to summarize the current literature investigating the short-term effect of a single dose of MBT on pain sensitivity in both healthy and clinical populations, with particular attention to specific MBT parameters of intensity and duration.

METHODS

A systematic search for articles meeting our prespecified criteria was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE from the inception of each database until July 2012, in accordance with guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analysis. Relevant characteristics from studies included type, intensity, and duration of MBT and whether short-term changes in pain sensitivity and clinical pain were noted with MBT application. Study results were pooled using a random-effects model to estimate the overall effect size of a single dose of MBT on pain sensitivity as well as the effect of MBT, dependent on comparison group and population type.

RESULTS

Reports from 24 randomized controlled trials (23 articles) were included, representing 36 MBT treatment arms and 29 comparative groups, where 10 groups received active agents, 11 received sham/inert treatments, and eight received no treatment. MBT demonstrated a favorable and consistent ability to modulate pain sensitivity. Short-term modulation of pain sensitivity was associated with short-term beneficial effects on clinical pain. Intensity of MBT, but not duration, was linked with change in pain sensitivity. A meta-analysis was conducted on 17 studies that assessed the effect of MBT on pressure pain thresholds. The results suggest that MBT had a favorable effect on pressure pain thresholds when compared with no-treatment and sham/inert groups, and effects comparable with those of other active treatments.

CONCLUSION

The evidence supports the use of pain sensitivity measures by future research to help elucidate optimal therapeutic parameters for MBT as an intermediate physiologic marker.

Effectiveness of a multidimensional physical therapy program on pain, pressure hypersensitivity, and trigger points in breast cancer survivors: a randomized controlled clinical trial

OBJECTIVE

To evaluate the effects of an 8-week multidimensional physical therapy program, including strengthening exercises and recovery massage, on neck and shoulder pain, pressure hypersensitivity, and the presence of active trigger points (TrPs) in breast cancer survivors.

METHODS

In this randomized controlled clinical trial, 44 breast cancer survivors were randomly assigned into 2 groups: CUIDATE group who received a multidimensional physical therapy program; or CONTROL group who received usual care treatment for breast cancer. CUIDATE program consisted of 24 hours of individual physical training (aerobic, mobility, stretching, and strengthening exercises) and 12 hours of physical therapy recovery (stretching, massage) interventions (3 times/wk, 90 min). Outcomes included neck and shoulder pain (visual analog scale, 0 to 100), pressure pain thresholds over the C5-C6 zygapophyseal joints, deltoid muscles, second metacarpal and tibialis anterior muscles, and the presence of active TrPs in shoulder muscles. Outcomes were assessed at baseline and after the 8-week program by a blinded assessor.

RESULTS

The CUIDATE group showed an estimated improvement for neck pain of -56 mm [95% confidence interval (CI), -71--40, P<0.001; effect size 2.72, 1.94 to 3.44] and for shoulder/axillary of -56 mm (95% CI, -74--38, P<0.001; effect size 2.45, 1.66 to 3.23). Improvements were also noted for pressure pain thresholds levels: C5-C6 zygapophyseal joints (between-group differences 101 kPa, 95% CI, 60-143; effect size 1.68, 1.00 to 2.35; 92 kPa 55 to 129; d: 1.98, 1.18 to 2.77), deltoid muscles (98 kPa, 45 to 149; d: 1.34, 0.62 to 2.04; 75 kPa 18 to 132; d: 1.12, 0.27 to 1.96), second metacarpal (93 kPa, 45 to 134; d: 1.30, 0.63 to 1.86; 99 kPa 59 to 139; d: 1.60, 0.96 to 2.24), and tibialis anterior muscles (71 kPa, 40 to 144; d: 1.16, 0.65 to 2.34; 118 kPa 57 to 178; d: 1.17, 0.56 to 1.77). Finally, patients within the CUIDATE program showed a greater reduction of active muscle TrPs compared with the CONTROL group (P<0.01).

CONCLUSIONS

An 8-week multidimensional program including strengthening exercises, and massage as major components was effective for improving neck and shoulder pain and reducing widespread pressure hyperalgesia in breast cancer survivors compared with usual care treatment.

The application of Reiki in nurses diagnosed with Burnout Syndrome has beneficial effects on concentration of salivary IgA and blood pressure

This study aimed to investigate the immediate effects of the secretory immunoglobulin A (sIgA), α-amylase activity and blood pressure levels after the application of a Reiki session in nurses with Burnout Syndrome. A randomized, double-blind, placebo-controlled, crossover design was conducted to compare the immediate effects of Reiki versus control intervention (Hand-off sham intervention) in nurses with Burnout Syndrome. Sample was composed of eighteen nurses (aged 34-56 years) with burnout syndrome. Participants were randomly assigned to receive either a Reiki treatment or a placebo (sham Reiki) treatment, according to the established order in two different days. The ANOVA showed a significant interaction time x intervention for diastolic blood pressure (F=4.92, P=0.04) and sIgA concentration (F=4.71, P=0.04). A Reiki session can produce an immediate and statistically significant improvement in sIgA concentration and diastolic blood pressure in nurses with Burnout Syndrome.

Attitudes towards massage modify effects of manual therapy in breast cancer survivors: a randomised clinical trial with crossover design

Our aims were to investigate the immediate effect of myofascial release on heart rate variability and mood state, and the influence of attitude towards massage in breast cancer survivors with cancer-related fatigue. Twenty breast cancer survivors reporting moderate to high cancer-related fatigue participated in this crossover study. All patients presented to the laboratory at the same time of the day on two occasions separated by a 2-week interval. At each session, they received either a massage intervention or control intervention. Holter electrocardiogram recordings and Profile of Mood States questionnaire (six domains: tension-anxiety, depression-dejection, anger-hostility, vigour, fatigue, confusion) were obtained before and immediately after each intervention. The attitude towards massage scale was collected before the first session in all breast cancer survivors. The results showed a significant session × time interaction for standard deviation of the normal-to-normal interval (SDNN) (F= 5.063, P= 0.039), square root of mean squared differences of successive normal-to-normal intervals (RMSSD) (F= 8.273, P= 0.010), high-frequency component (HF) (F= 7.571, P= 0.013), but not for index heart rate variability (F= 3.451, P= 0.080), low-frequency component (LF) (F= 0.014, P= 0.997) and ratio LF/HF (F= 3.680, P= 0.072): significant increases in SDNN, RMSSD and HF domain (P < 0.05) were observed after the manual therapy intervention, with no changes after placebo (P > 0.6). No influence of the attitude scale on heart rate variability results was found. A significant session × time interaction was also found for fatigue (F= 5.101, P= 0.036) and disturbance of mood (F= 6.690, P= 0.018) scales of the Profile of Mood States: patients showed a significant decrease in fatigue and disturbance of mood (P < 0.001) after manual therapy, with no changes after placebo (P > 0.50). A significant influence of the attitude scale was observed in tension-anxiety, depression-dejection and anger-hostility scales. This controlled trial suggests that massage leads to an immediate increase of heart rate variability and an improvement in mood in breast cancer survivors with cancer-related fatigue. Further, the positive impact of massage on cancer-related fatigue is modulated by the attitude of the patient towards massage.

Effectiveness of core stability exercises and recovery myofascial release massage on fatigue in breast cancer survivors: a randomized controlled clinical trial

The purpose of the present paper was to evaluate the effects of an 8-week multimodal program focused on core stability exercises and recovery massage with DVD support for a 6-month period in physical and psychological outcomes in breast cancer survivors. A randomized controlled clinical trial was performed. Seventy-eight (n = 78) breast cancer survivors were assigned to experimental (core stability exercises plus massage-myofascial release) and control (usual health care) groups. The intervention period was 8 weeks. Mood state, fatigue, trunk curl endurance, and leg strength were determined at baseline, after the last treatment session, and at 6 months of followup. Immediately after treatment and at 6 months, fatigue, mood state, trunk curl endurance, and leg strength exhibited greater improvement within the experimental group compared to placebo group. This paper showed that a multimodal program focused on core stability exercises and massage reduced fatigue, tension, depression, and improved vigor and muscle strength after intervention and 6 months after discharge.

Dry needling for myofascial pain: prognostic factors

OBJECTIVES

The study objectives were to evaluate outcomes in patients who have received dry needling treatments and to identify predictors of pain and disability.

DESIGN

The study was a prospective cohort follow-up design.

SETTING

The study was conducted at the Pain Clinic at Pingtung Christian Hospital, Taiwan.

SUBJECTS

Ninety-two (92) patients sick-listed for 3 months or longer for myofascial pain syndrome.

INTERVENTIONS

From February to October 2008, participants were treated at the pain clinic with dry needling of trigger points and muscle stretches of the involved muscles.

OUTCOME MEASURES

Data were collected by self-administered questionnaires to assess changes in pain intensity and pain interference. Data collection was performed at baseline and after 2, 4, and 8 weeks. Sociodemographic variables, symptom characteristics, and baseline outcome measures were analyzed using generalized estimating equation methodology.

RESULTS

The proposed dry-needling protocol reduced pain intensity and pain interference. Long duration of pain symptoms, high pain intensity, poor quality of sleep, and repetitive stress were associated with poor outcomes.

CONCLUSIONS

Dry needling is an effective treatment for reducing pain and pain interference. However, long pain duration, high pain intensity, poor quality of sleep, and repetitive stress are associated with poor outcomes. Treatment outcome depends not only on the dry needling protocol, but also on disease characteristics and patient demographic profile.