Whole-body vibration decreases delayed onset muscle soreness following eccentric exercise in elite hockey players: a randomised controlled trial

What We Do Not Know About Stretching in Healthy Athletes: A Scoping Review with Evidence Gap Map from 300 Trials

BACKGROUND

Stretching has garnered significant attention in sports sciences, resulting in numerous studies. However, there is no comprehensive overview on investigation of stretching in healthy athletes.

OBJECTIVES

To perform a systematic scoping review with an evidence gap map of stretching studies in healthy athletes, identify current gaps in the literature, and provide stakeholders with priorities for future research.

METHODS

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and PRISMA-ScR guidelines were followed. We included studies comprising healthy athletes exposed to acute and/or chronic stretching interventions. Six databases were searched (CINAHL, EMBASE, PubMed, Scopus, SPORTDiscus, and Web of Science) until 1 January 2023. The relevant data were narratively synthesized; quantitative data summaries were provided for key data items. An evidence gap map was developed to offer an overview of the existing research and relevant gaps.

RESULTS

Of ~ 220,000 screened records, we included 300 trials involving 7080 athletes [mostly males (~ 65% versus ~ 20% female, and ~ 15% unreported) under 36 years of age; tiers 2 and 3 of the Participant Classification Framework] across 43 sports. Sports requiring extreme range of motion (e.g., gymnastics) were underrepresented. Most trials assessed the acute effects of stretching, with chronic effects being scrutinized in less than 20% of trials. Chronic interventions averaged 7.4 ± 5.1 weeks and never exceeded 6 months. Most trials (~ 85%) implemented stretching within the warm-up, with other application timings (e.g., post-exercise) being under-researched. Most trials examined static active stretching (62.3%), followed by dynamic stretching (38.3%) and proprioceptive neuromuscular facilitation (PNF) stretching (12.0%), with scarce research on alternative methods (e.g., ballistic stretching). Comparators were mostly limited to passive controls, with ~ 25% of trials including active controls (e.g., strength training). The lower limbs were primarily targeted by interventions (~ 75%). Reporting of dose was heterogeneous in style (e.g., 10 repetitions versus 10 s for dynamic stretching) and completeness of information (i.e., with disparities in the comprehensiveness of the provided information). Most trials (~ 90%) reported performance-related outcomes (mainly strength/power and range of motion); sport-specific outcomes were collected in less than 15% of trials. Biomechanical, physiological, and neural/psychological outcomes were assessed sparsely and heterogeneously; only five trials investigated injury-related outcomes.

CONCLUSIONS

There is room for improvement, with many areas of research on stretching being underexplored and others currently too heterogeneous for reliable comparisons between studies. There is limited representation of elite-level athletes (~ 5% tier 4 and no tier 5) and underpowered sample sizes (≤ 20 participants). Research was biased toward adult male athletes of sports not requiring extreme ranges of motion, and mostly assessed the acute effects of static active stretching and dynamic stretching during the warm-up. Dose-response relationships remain largely underexplored. Outcomes were mostly limited to general performance testing. Injury prevention and other effects of stretching remain poorly investigated. These relevant research gaps should be prioritized by funding policies.

REGISTRATION

OSF project ( https://osf.io/6auyj/ ) and registration ( https://osf.io/gu8ya ).

Effects of combined treatment with transcranial and peripheral electromagnetic stimulation on performance and pain recovery from delayed onset muscle soreness induced by eccentric exercise in young athletes. A randomized clinical trial

Background: There is a common interest in finding a common consensus in the approach of athletes suffering from DOMS with the aim of accelerating recovery and thereby enhancing performance. The objective of this study was to observe the effects of a paired-associative transcranial and peripheral electromagnetic stimulation on young athletes suffering from DOMS, induced by 1 h of eccentric and plyometric exercises. Methods: Forty-eight young athletes participated in this randomized control trial: 13 were assigned to the peripheral group (P); 12 were in the control group (Cont); 11 were assigned to the transcranial group (T) and 12 were included in the paired-associative group (Comb). The Visual Analogue Scale (VAS) of pain perception and the mechanical Pressure Pain Threshold (PPT) were the tools used to analyze the symptoms of DOMS. On the other hand, the Half Squat (HS) test evaluated with an accelerometer, and the 30 m sprint velocity (30-mSP) test were used to observe the evolution of the sports performance of the lower limbs. All evaluations were performed before and after the eccentric exercise session that caused DOMS, as well as at 24-48, and 72 h afterward. Results: The AS group improved the symptoms of the induced DOMS, since significant positive differences were observed in the VAS and PPT compared to the other groups (p < 0.001). In addition, the AS group showed a significant improvement in the HS and the 30-mSP tests (p < 0.001). Based on the results a treatment with both peripheral and transcranial electromagnetic stimulation improves recovery and performance in athletes at 72 h, although these data would need to be verified in future research with a larger sample size. Conclusion: Paired-associative electromagnetic stimulation improved DOMS symptomatology, velocity, and sports performance in the lower limbs.

Effects of Vibrotherapy with Different Characteristics and Body Position on Post-Exercise Recovery after Anaerobic Exercise

The aim of this project was to indicate the optimal parameters such as frequency, duration of a single vibrotherapy, and body position, which will be used as a form of recovery modality after physical exercise. Sixteen healthy male volunteers were involved in this study. The aerobic and anaerobic capacity of participants was assessed. Each of the subjects performed a set of intensive physical exercises and then underwent vibrotherapy treatment. In random order, each of the men tested the effectiveness of eight of the combinations of frequency, duration, and body position. The effect of the procedure accelerating recovery was assessed 24 h after physical exercise with the Wingate test. Changes in oxygen saturation and biochemical markers (interleukins: Il-1β, Il-6, and creatine kinase: CK), hemoglobin (Hb), and hematocrit (Hct) were assessed 1 h and 24 h after the physical effort. Lactate concentrations were measured 3, 15, 30, and 60 min after the end of the vibration. It was indicated that the optimal treatment should be based on lower ranges of frequency values (2-52 Hz). The procedure with raised feet is also more beneficial than the flat, supine position. To improve the overall work, and a number of biochemical markers (CK and Il-1β), a 45 min treatment will be more efficient, because significantly lower CK activity was indicated for the 45 min treatment. For this duration, higher values of Il-1β were indicated in the measurement carried out for samples collected 60 min after the treatment and lower in the measurement carried out 24 h after the treatment.

Effect of Kinesio tape and Compression sleeves on delayed onset of muscle soreness: a single-blinded randomized controlled trial

BACKGROUND

Both Kinesio Tape (KT) and Compression Sleeves (CS) can relieve Delayed Onset Muscle Soreness (DOMS) to a certain extent, but there is no study report on the difference in the effectiveness of the KT and CS whether the effect is better when used at the same time. The purpose of this study was to compare the effects of KT and CS on the recovery of muscle soreness, isokinetic strength, and body fatigue after DOMS.

METHODS

In this single-blinded randomized controlled trial, 32 participants aged 18 to 24 years were randomly divided into Control group (CG), Compression Sleeves group (CSG), Kinesio Tape group (KTG), Compression Sleeves and Kinesio Tape group (CSKTG), between October 2021 and January 2022. KTG uses Kinesio Tape, CSG wears Compression Sleeves, and CSKTG uses both Compression Sleeves and Kinesio Tape. Outcomes were performed at five-time points (baseline, 0 h, 24 h, 48 h, 72 h), Primary outcome was pain level Visual Analogue Scale (VAS), and Secondary outcomes were Interleukin 6, Peak Torque/Body Weight, Work Fatigue. Statistical analyses were performed using the repeated measures analysis of variance method.

SETTING

Laboratory.

RESULTS

After the intervention, VAS reached the highest at 24 h after exercise-induced muscle soreness, while the KTG and CSG at each time point were less than CG, and the scores of CSKTG at 24 h and 48 h were less than those of KTG and CSG in the same period (P < 0.05). Interleukin 6, at 24 h, CSKTG is lower than KTG 0.71(95%CI: 0.43 to 1.86) and CG 1.68(95%CI: 0.06 to 3.29). Peak Torque/Body Weight, at 24 h, CG was lower than CSKTG 0.99(95%CI: 0.42 to 1.56), KTG 0.94(95%CI: 0.37 to 1.52), and CSG 0.72(95%CI: 0.14 to 1.29); at 72 h, CG was lower than CSKTG 0.65(95%CI: 0.13 to 1.17) and KTG 0.58(95%CI: 0.06 to 1.10). Work Fatigue, at 24 h, CG was lower than KTG 0.10(95%CI: 0.02 to 1.78) and CSKTG 0.01(95%CI: -0.07 to 0.09). At 48 h, CG was lower than KTG 0.10(95%CI: 0.13 to 1.17) and CSKTG 0.11(95%CI: 0.03 to 0.18).

CONCLUSIONS

Kinesio Tape can significantly reduce DOMS pain, and Kinesio Tape has a better recovery effect on Delayed Onset Muscle Soreness than Compression Sleeves. Kinesio Tape combined with Compression Sleeves is helpful to alleviate the Delayed Onset Muscle Soreness pain, speeding up the recovery of muscle strength, and shortening the recovery time after Delayed Onset Muscle Soreness.

TRIAL REGISTRATION

Registration number: This study was also registered on 11/10/2021, at the Chinese Clinical Trial Registry (ChiCTR2100051973).

Correlation of Delayed Onset Muscle Soreness and Inflammation Post-exercise Induced Muscle Damage

BACKGROUND: Delayed Onset Muscle Soreness (DOMS) is a common injury resulting from abnormal intensive training in athletes, mainly the result of training involving eccentric contractions. AIM: The aim of this study was to determine the correlation between the incidence of DOMS and HMGB1 as a marker of the occurrence of inflammation post Exercise Induces Muscle Damaged. METHOD: 28 male recreational students of Sports Science Department, Universitas Negeri Surabaya who met all inclusion and exclusion criteria participated in this study. Participants completed a muscle damaging exercise which consists of a 10x10 drop jump (DRP) and a bout of 40×15 m sprints with a 5 m deceleration zone (SPR) to obtain a muscle damage effect. In this study, the stretching in the exercise session was not given, this was done to get the DOMS effect after exercise. DOMS and HMGB1 was carry out 1 hour before the exercise, 12 hours after the exercise, 24 hours after the exercise and 48 hours after the exercise. RESULT: The result showed that there was a significant correlation (r=0.935, p<0.05) between DOMS and HMGB1 as a predictor of inflammation. The participants that were given EIMD eccentric exercise (DRP and SPR) showed the occurrence of DOMS and increasing of HMGB1. The result also showed that there was a correlation between DOMS and HMGB1. CONCLUSION: This study concluded that there was a correlation between DOMS and HMGB1 as a marker of inflammation as the result of the eccentric exercise of the exercise Induced Muscle Damage (EIMD).

The effect of vibration training on delayed muscle soreness: A meta-analysis

BACKGROUND

Delayed onset muscle soreness (DOMS) is caused by unaccustomed exercise, especially eccentric exercise, and is highly likely to cause skeletal muscle injury. It mainly manifests as ultrastructural changes in skeletal muscle, as well as decreased muscle strength, muscle soreness, swelling, and elevated levels of creatine kinase (CK). Vibration training (VT) has been attracting increasing attention as a new type of rehabilitation therapy. It can effectively minimize the occurrence and relieve the symptoms of DOMS, reduce muscle stiffness and soreness, and reduce serum concentrations of CK and lactate dehydrogenase (LDH). This article systematically assessed the impact of VT on the mitigation of DOMS through a meta-analysis to provide updated evidence-based information.

METHODS

Electronic databases such as China Knowledge Network, VIP Electronics, PubMed, EBSCO, and Web of Science were searched to identify randomized controlled trials of VT on DOMS. Searches were performed from database creation to November 2021. The quality of the literature was assessed using the Cochrane Manual for the Systematic Review of Interventions, and meta-analyses were performed using RevMan 5.4 software.

RESULTS

VT intervention in DOMS was shown to effectively reduce subjective pain, improve pain tolerance, and accelerate the reduction of serum CK and LDH concentrations. Subgroup analysis of different test time periods showed that subjective pain decreased more significantly after 48 hours than after the other 2 time periods, and pain tolerance increased more significantly after 72 hours than the other 2 time periods; serum CK was significantly increased after 24 and 48 hours of intervention, but showed no significant change compared with the control group after 72 hours. Serum LDH decreased significantly after 24 hours of intervention, but there was no significant difference compared with the control group after 48 hours or 72 hours.

CONCLUSION

VT effectively reduced the subjective pain sensation after DOMS, increased the pain threshold, reduced serum LDH and CK concentrations, and accelerated muscle damage repair compared with control interventions. However, the effect of improving the range of motion of the joints is not clear and should be studied further.

REGISTRATION

number: INPLASY2021120115.

Effect of vertical vibration stimulation at different frequencies on delayed muscle soreness in athletes: A randomized trial

Background

The effect of stimulation with different vibration frequencies on delayed muscle soreness (DOMS) has not yet been determined. This study was conducted to investigate the effect of medium- and high-frequency vertical vibration stimulation on DOMS in track and field athletes.

Methods

A total of 38 elite men's track and field athletes were recruited during the off-season. Through the digital randomization method, the participants were divided into three groups. Two-knee DOMS modeling was performed on the medium-frequency group (MFG, 25 Hz, n = 13), high-frequency group (HFG, 50 Hz, n = 12) and control group (CG, 0 Hz, n = 13). The three groups were matched in age, height and body mass. Vertical vibration stimulation was performed for 10 min on the MFG and HFG. Visual analog score (VAS); interleukin-6 (IL-6), lactic dehydrogenase (LDH) and creatine kinase (CK) levels and knee extension peak torque (PT) were determined immediately and at 24, 48, and 72 h after vibration.

Results

The 48 and 72 h VASs of the HFG were lower than those of the MFG and CG. The immediate and 24 and 48 h IL-6 concentrations in the HFG were lower than those in the CG. The 24 h IL-6 concentration in the HFG was lower than that in the MFG and that in the MFG was lower than that in the CG. LDH concentrations at different time points did not differ amongst groups. Immediate and 24 h CK concentrations were lower in the HFG than in the CG. The immediate and 24, 48, and 72 h knee extensions at 60°/s PT were lower in the HFG than in the CG. The immediate and 24 and 48 h knee extension at 60 °/s PT in the MFG were lower than those in the CG. The 24 h knee extension (240°/s peak torque) value in the HFG was lower than that in the CG.

Conclusion

Stimulation with 50 Hz (amplitude of 3 mm) vibration can reduce the muscle pain, IL-6 and CK concentrations and knee extension loss caused by DOMS. However, stimulation with 25 Hz (amplitude of 3 mm) vibration had poor effects. Results suggested that high-frequency vibration training is an effective strategy for relieving DOMS after intensive training.

Return to play after treating acute muscle injuries in elite football players with radial extracorporeal shock wave therapy

Background

To compare lay-off times achieved by treating acute muscle injuries in elite football players with a multimodal therapy approach that includes a specific protocol of almost daily radial extracorporeal shock wave therapy (rESWT) with corresponding data reported in the literature.

Methods

We performed a retrospective analysis of treatments and recovery times of muscle injuries suffered by the players of an elite football team competing in the first/second German Bundesliga during one of the previous seasons.

Results

A total of 20 acute muscle injuries were diagnosed and treated in the aforementioned season, of which eight (40%) were diagnosed as Type 1a/muscular tightness injuries, five (25%) as Type 2b/muscle strain injuries, four (20%) as Type 3a/partial muscle tear injuries and three (15%) as contusions. All injuries were treated with the previously mentioned multimodal therapy approach. Compared with data reported by Ekstrand et al. (Br J Sports Med 47:769–774, 2013), lay-off times (median/mean) were shortened by 54% and 58%, respectively, in the case of Type 1a injuries, by 50% and 55%, respectively, in the case of Type 2b injuries as well as by 8% and 21%, respectively, in the case of Type 3a injuries. No adverse reactions were observed.

Conclusions

Overall, the multimodal therapy approach investigated in this study is a safe and effective treatment approach for treating Type 1a and 2b acute muscle injuries amongst elite football players and may help to prevent more severe, structural muscle injuries.