The Mechanisms of Massage and Effects on Performance, Muscle Recovery and Injury Prevention

Self-Powered Algae-Integrated Wearable System for Oxygen Supplementation in Hypoxic Disease Treatment

Hypoxia serves as a critical determinant in the advancement of various intractable pathological conditions including oncological disorders and hypovascular wounds, which may profoundly attenuate the efficacy of pharmacological interventions and substantially inhibit the physiological recovery processes. Consequently, in an effort to mitigate the inherent constraints of conventional methodologies (e.g., exogenous oxygen delivery systems), a self-powered triboelectric nanogenerator (TENG)-based algae-integrated pliable and enveloped device (TAPED) operates as a wearable system to sustain oxygen generation. The TAPED system harnesses biomechanical energy generated through natural bodily movements to energize an integrated luminescent source, enabling controlled photosynthesis for sustained, on-demand oxygen production. The incorporation of TENG technology renders TAPED self-sufficient, eliminating the necessity for external recharging, reducing device mass, and improving convenience for continuous oxygen delivery. Additionally, its body-attachable design circumvents risks associated with direct algal implantation, such as immunogenic reactions and infections. Specifically, experimental application of TAPED has exhibited significant therapeutic efficacy in diverse pathological conditions, including diabetic chronic infected wounds, breast carcinoma tumors, and lactic acid accumulation consequent to strenuous exercise-induced fatigue. Collectively, the TAPED represents an advanced therapeutic approach, which holds substantial potential for translational application within clinical contexts, particularly for enhancing patient prognosis in hypoxic diseases such as oncology and wound management.

Immediate effect of ice and dry massage during rest breaks on recovery in MMA fighters : a randomized crossover clinical trial study

The MMA fight consists of 5 rounds of 5 min with minimal breaks between the rounds. The exertion load is excessive for the fighters, and the 1-minute breaks give little time for any intervention. This study aimed to examine the acute effects of two methods of regenerative strategies, ice massage and dry massage, and analyze their impact on Reactive Strength Index (RSI - m s- 1), muscles' biomechanical properties: muscle tone (T-Hz), elasticity (E - arb- relative arbitrary unit), stiffness (S - N/m), pressure pain threshold, (PPT - N/cm²), and compare their influence with passive rest. The maximum number of jumps (J - n) treated as an indirect effective measure of the interventions that were conducted was also recorded for each participant in each regenerative strategy. Thirty male MMA fighters took part in the study. Three subgroups of 10 participants (Ice massage, n = 10; dry massage, n = 10; and control, n = 10) were enrolled in the cross-over randomized clinical trial study design. The groups were randomized, and each group underwent each procedure (30 tested in each procedure). Five sets of jumps on a 50 cm box to exhaustion were used as a fatigue protocol with 1-minute breaks. The recovery interventions were performed during the breaks. The statistically significant results revealed in the post-exercise tests: RSI and number of jumps - the lowest decrease was observed in the massage group (p < 0.001 and p < 0.0001 respectively), the minor increases in T, E and S were also observed in the massage group ((p < 0.0001 for all measurements); the post-exercise PPT was the highest (higher means better) in the Ice group (p < 0.001). In every other parameter, the ice massage group showed slightly worse results than the dry massage group. Responder analysis confirms that the number of jumps profoundly impacted biomechanical variables, leading to increased muscle stiffness and tension, decreased elasticity and force endurance, and heightened pain sensitivity. Obtained results confirm that both dry and ice massage can significantly affect acute recovery following rounds of combat sport-related exertions. The Ice and Massage interventions differed in effectiveness - Massage was the most effective in preventing increases in stiffness and tension and preserving muscle elasticity. At the same time, ice cooling had a lesser impact, particularly on muscle elasticity changes but higher for PPT.

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.

The Comparison of Mechanical Percussion Therapy and Manual Stretching on Hamstring Length

Background

The interest in and use of mechanical percussive massage treatment devices have grown immensely among clinicians and athletes. One purported benefit of these devices is the improvement of range of motion but whether these devices are more effective than traditional means of increasing muscle extensibility remains unexplored.

Purpose

To examine the effect of mechanical percussive massage therapy applied to the hamstrings versus static stretching of the hamstrings on passive knee extension (PKE) range of motion.

Study Design

Randomized control trial.

Methods

Male Division II NAIA and Division III NCAA football players were recruited. Subjects were randomly assigned to one of three groups: control, mechanical percussive massage therapy, or static stretching. Passive hamstring extensibility was quantified in all groups using standard goniometric measurements before and after the intervention by measuring PKE three times in a 90-90 supine position. The mechanical percussive massage therapy group received five minutes of treatment to the hamstrings. The static stretching group received manual stretching of the hamstrings performed in the 90-90 supine position (3 repetitions of 30 seconds with 10-second rest between repetitions). The control group received no treatment. An ANOVA was used to investigate effects of the random interventions.

Results

Seventy-nine male collegiate football players, 37 NCAA Division III and 42 NAIA Division II (mean age 19.8 years +/- 1.2) participated in this study. A significant difference (p < .001) in pre- and post-PKE range of motion was noted for both the percussive mechanical massage therapy (5.8 degrees, SD+/- 3.32) and static stretching (6 degrees, SD+/- 3.29) groups. No significant difference was noted between the two treatment groups. The control group did not demonstrate a significant difference in pre and post-PKE (1.1 degrees, SD +/- 3.62).

Conclusions

Static stretching and mechanical percussive massage therapy applied to the hamstrings produce significant immediate increases in PKE compared to a control group suggesting that static hamstring stretching, and mechanical percussive massage therapy are both viable options for acutely increasing hamstring extensibility.

Level of Evidence

II.

The Effect of Tissue Stretching and Release Strategies on Neck Muscles Fatigue and Pain Intensity in Office Workers Affected by Chronic Neck Pain: A Rater-Blind, Semi-Experimental Study

Background and Aims

Nonspecific chronic neck pain (ns-CNP) is a common cause of disability among office workers. However, the effectiveness of tissue release and stretching strategies in managing pain and fatigue of neck muscles in employees affected by ns-CNP has not been assessed.

Methods

Thirty-nine employees who suffered from ns-CNP were randomly assigned to stretching, tissue release interventions or control group (n = 13). Neck pain and fatigue in neck extensors, upper trapezius, and sternocleidomastoid muscles were measured during 40 min of typing with a 45-degree head flexion at baseline and immediately after a 6-week intervention using visual analog scale and surface electromyography.

Results

Pain significantly decreased after 6 weeks of both interventions (p < 0.05). There were no significant within-group differences for right cervical muscle fatigue in the intervention groups, but a significant difference was noted in the control group at the 25th and 40th minutes (p < 0.05). Additionally, a significant difference was observed between the release and control group at the 30th, 35th, and 40th minutes (p < 0.05). Left cervical muscle fatigue significantly decreased at the 25th and 40th minutes only for the release group (p < 0.05). A significant difference was observed between the release and control groups at the 40th minute for the right upper trapezius (p < 0.05).

Conclusion

Only the stretching group showed a significant difference with the control in the left sternocleidomastoid at the 10th and 15th minutes, and the release group with the control in the last 5-min. Stretching and release interventions could control neck pain and muscle fatigue in the 45-degree head flexion position.

The effect of percussion massage therapy on the recovery of delayed onset muscle soreness in physically active young men-a randomized controlled trial

Background

Delayed onset muscle soreness (DOMS) is a common condition among physically active individuals, often resulting in reduced performance and discomfort. Although percussive massage treatment (PMT) is widely used as a recovery tool, there is limited evidence supporting its efficacy compared to traditional methods such as static stretching.

Objective

To investigate the effect of PMT on recovery from DOMS in physically active young men.

Methods

Thirty physically active male college students were randomized into three groups: static stretching (SS) group, a short-duration PMT (S-PMT) group, and a long-duration PMT (L-PMT) group. All participants performed squats to induce DOMS, followed by interventions of static stretching, 25 min of PMT, or 40 min of PMT, respectively. Measurements included the visual analog scale (VAS) pain score, knee joint range of motion (ROM), countermovement jump (CMJ), and integrated electromyography (iEMG). These were measured at baseline (P0), post-DOMS protocol (P1), post PMT (P2), 24 h post-intervention (P3), and 48 h post-intervention (P4). Data were analyzed using repeated-measures ANOVA or nonparametric tests, with multiple comparisons conducted at a significance level of p < 0.05.

Results

Compared with the SS and S-PMT group, the L-PMT group at P4 demonstrated significantly greater jump height (SS group: p < 0.001, d = 8.691; S-PMT group: p = 0.006, d = 4.37), peak ground reaction force (SS group: p < 0.001, d = 19.174; S-PMT group: p < 0.001, d = 14.334), and propulsion impulse (SS group: p < 0.001, d = 8.302; S-PMT group: p = 0.003, d = 4.517) during the CMJ propulsion phase. Additionally, the normalized iEMGs of the three muscles in the L-PMT group were significantly lower than those in the S-PMT (VM: p < 0.001, d = -5.692; RF: p < 0.001, d = -8.222; VL: p < 0.001, d = -10) and SS groups at P4 (VM: p < 0.001, d = -12; RF: p < 0.001, d = -11.384; VL: p < 0.001, d = -15). At P4, the L-PMT group exhibited significantly lower VAS scores than the SS group (p = 0.003, d = -1.53), as well as significantly greater knee joint ROM compared to the SS group (p = 0.012,d = 4.77).

Conclusion

PMT was more effective than static stretching for DOMS recovery. Furthermore, two 40-min PMT sessions provided greater benefits than two 25-min sessions for treating DOMS. These findings suggest that PMT can be a valuable tool for physically active individuals seeking to enhance recovery and maintain performance.

Clinical trial registration

The study was registered on ClinicalTrials.gov on September 21, 2024, with the identifier number NCT06612502.

The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews

INTRODUCTION

Treatment mechanisms are the underlying process or pathway through which a treatment influences the body. This includes molecular, cellular and physiological processes or pathways contributing to treatment effect. Manual therapy (MT) evokes complex mechanistic responses across body systems, interacting with the individual patient and context to promote a treatment response. Challenges arise as mechanistic studies are spread across multiple professions, settings and populations. The purpose of this review is to summarize treatment mechanisms that have been reported to occur with MT application.

METHODS

Four electronic databases were searched (Medline, CINAHL, Cochrane Library, and PEDro) for reviews investigating mechanistic responses which occur during/post application of MT. This review was registered a priori with PROSPERO (CRD42023444839). Methodological quality (AMSTAR-2) and risk of bias (ROBIS) were assessed for systematic and scoping reviews. Data were synthesized by mechanistic domain.

RESULTS

Sixty-two reviews were included. Systematic reviews (n = 35), narrative reviews (n = 24), and scoping reviews (n = 4) of asymptomatic (n = 37), symptomatic (n = 43), non-specified human subjects (n = 7) and animals (n = 7) were included. Reviews of moderate quality supported neurovascular, neurological, and neurotransmitter/neuropeptide changes. Reviews of low quality supported neuroimmunce, neuromuscular, and neuroendocrine changes. Reviews of critically low quality support biomechanical changes.

CONCLUSIONS

Findings support critically low to moderate quality evidence of complex multisystem mechanistic responses occurring with the application of MT. Results support peripheral, segmental spinal, and supraspinal mechanisms occurring with the application of MT, which can be measured directly or indirectly. The clinical value of these findings has not been well established. While MT has proven to be an effective intervention to treat conditions such as pain, the current body of literature leaves uncertainty as to 'why' MT interventions work, and future research should look to better define which mechanisms (or combinations of mechanisms) are mediators of clinical response.

Foam Roller Post-High-Intensity Training for CrossFit Athletes: Does It Really Help with Recovery?

Background/Objectives: Foam rolling is a new and emergent recovery tool in sports. The aim of this study seeks to compare the acute effects of foam rolling and passive rest on recovery markers in CrossFit athletes following a high-intensity workout. Methods: A quasi-experimental crossover study design was completed with 14 amateur CrossFit athletes. Participants completed the FRAN CrossFit WOD and then completed a recovery protocol including either a foam roller or passive rest. Heart rate, blood lactate, and perceived exertion were collected at three time points (pre-workout, post-WOD, and post-recovery). Results: The foam rolling group had no significant differences from the passive rest group on recovery markers. Blood lactate increased significantly post-WOD in both groups, yet there was no significant difference in blood lactate post-recovery. Perceived exertion and heart rate had a similar pattern to blood lactate. Conclusions: High-intensity training causes significant physiological changes; however, foam rolling offers no additional benefit over passive rest for lactate clearance, heart rate recovery, and perceived exertion. CrossFit athletes can choose their preferred method of recovery based on personal preference, as foam rolling neither enhances nor hinders recovery.

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.

Sex and pressure effects of foam rolling on acute range of motion in the hamstring muscles

This study investigated the effects of pressure levels and sex on acute range of motion (ROM) changes during foam rolling (FR) using a soccer ball. Twenty collegiate athletes (10 males, 10 females) performed FR on their hamstrings at low (15-25% body weight) or high (45-55%) pressure levels for 2 minutes. ROM was assessed through passive straight leg raise (PSLR) and passive knee extension (PKE) tests before, immediately after, and 10 minutes post-intervention. Results showed that FR significantly improved hip and knee ROM across all conditions, with benefits persisting for at least 10 minutes. No notable differences were observed between pressure levels, and sex did not affect the magnitude of improvement. Perceived pain during FR did not significantly influence ROM outcomes. These findings demonstrate that FR using a simple tool like a soccer ball is beneficial for improving ROM in both males and females, regardless of pressure intensity. This suggests that FR provides a practical, accessible method for improving ROM in athletes and other populations.

Effects of Sensory-Based Interventions on Delirium Prevention in Critically Ill Patients: A Systematic Review and Meta-Analysis

OBJECTIVE

To identify, appraise and synthesize current evidence on different sensory-based interventions on delirium prevention in critically ill patients.

DATA SOURCES

A comprehensive electronic literature search was performed in the PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, Wanfang and WeiPu databases from inception to 2 June 2022. The data were updated on 24 December 2022. The study was registered on PROSPERO (CRD 42021254328).

REVIEW METHODS

Randomized controlled trials were included. Participants in the included studies were critically ill patients aged 18 years or older, and the interventions involved care by sensory-based intervention. And the outcome was the incidence of delirium rated by the Confusion Assessment Method for the ICU Tool.

RESULTS

The 14 studies included in the systematic review indicated a reduction in the effectiveness of sensory-based intervention on the incidence of delirium. Subgroup analyses showed significant effects for auditory stimulation (OR, 0.46; 95% confidence interval [CI], 0.27-0.79; p = 0.005) and tactile stimulation (OR, 0.53; 95% CI, 0.33-0.87; p = 0.01) but not for the effectiveness of visual intervention on the incidence of delirium (OR, 0.71; 95% CI, 0.38-1.30; p = 0.27).

CONCLUSIONS

Sensory-based interventions significantly reduce the incidence of delirium in critical patients. It is suggested that when choosing sensory-based interventions, auditory intervention should be preferred.

Acute Effects of Foam Rolling and Stretching on Physical Performance and Self-Perceived Fatigue in Young Football Players

Background/Objectives: The aim of this study was to examine the acute effects of foam rolling and traditional stretch treatments on physical performance and self-perceived fatigue in youth football players. Methods: The sample of participants consisted of 20 youth football players from the Serbia Under-17 league. Participants were randomly assigned to one of two groups, the Foam group (age: 16.6 ± 1.5 years) or the Stretch group (age: 16.9 ± 1.0 years), with each group consisting of 10 participants. The first measurement (I) was conducted before the match; then, the football players played the match, which was followed by the second measurement (II), and afterward, the groups performed their foam and stretch activities. The third measurement (III) was conducted 2 h after the recovery interventions, and the fourth measurement (IV) was conducted 24 h after the match. Players were tested for the following: linear sprints at 5 m, 10 m, and 20 m, squat jumps (SJs), countermovement jumps (CMJs), and arm-driven countermovement jumps (ACMJs). Participants also completed self-assessment questionnaires on fatigue (Hooper scales) and perceived exertion (Borg scales). Results: A 2 × 4 split-plot ANOVA revealed that there were no differences between the foam rolling and stretching treatments in any parameter of physical performance or self-perceived fatigue. However, a separate within-group analysis showed that the Foam group achieved significantly better sprint times in the third and fourth measurements (2 and 24 h post-match, respectively) compared to measurements taken immediately after the football match. Regarding self-perceived parameters, foam rolling reduced fatigue and stress at 2 and 24 h post-match. On the other hand, the stretching treatment only affected the stress parameter, which was reduced 24 h after the football match. Conclusions: These findings indicate that although there were no significant differences between treatments, foam rolling demonstrated certain advantages compared to stretching. Specifically, foam rolling may offer benefits in enhancing subjective recovery and reducing perceived exertion in young football players. However, these conclusions should be interpreted with caution, as the study was cross-sectional and involved a small sample of young football players.

Effect of hand massage after abdominal surgery on pain, emotional symptoms and physiological parameters among children

AIM

This randomized controlled study aimed to evaluate the effect of hand massage on pain, emotional symptoms, and physiological parameters in children after abdominal surgery.

MATERIALS AND METHODS

The study included 40 children aged 7-12 years who underwent abdominal surgery (20 intervention, 20 control). Data were collected using the Faces Pain Scale-Revised, Children's Emotion Manifestation Scale, Physiological Measurements Chart, and Child Information Form. The intervention group received a 10-min hand massage 3 h after surgery, and measurements were taken before the massage, immediately after the massage, and 30 min after the massage. Statistical analyses were performed using the Mann-Whitney U, Friedman, and Bonferroni tests.

RESULTS

Immediately after the massage, the pain and emotional manifestation scores were significantly lower in the intervention group compared to the control group (p < 0.05). However, no significant difference was found between the two groups at the third measurement (p = 0.478). Heart rate significantly decreased in the intervention group immediately after the massage (p < 0.001), while it significantly increased in the control group (p < 0.001).

The Effects of Near-Infrared Phototherapy Preirradiation on Lower-Limb Muscle Strength and Injury After Exercise: A Systematic Review and Meta-analysis

OBJECTIVE

To assess near-infrared preirradiation effects on postexercise lower-limb muscle damage and function and determine optimal dosage.

DATA SOURCES

PubMed, Embase, Cochrane Library, EBSCO, Web of Science, China National Knowledge Infrastructure, and Wanfang Data were systematically searched (2009-2023).

STUDY SELECTION

Randomized controlled trials of near-infrared preirradiation on lower-limb muscles after fatigue exercise were incorporated into the meta-analysis. Out of 4550 articles screened, 21 met inclusion criteria.

DATA EXTRACTION

The included studies' characteristics were independently extracted by 2 authors, with discrepancies resolved through discussion or by a third author. Quality assessment was performed using the Cochrane risk of bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation System.

DATA SYNTHESIS

In 21 studies, near-infrared preirradiation on lower-limb muscles inhibited the decline in peak torque (standardized mean difference [SMD], 1.33; 95% confidence interval [CI], 1.08-1.59; p<.001; increasing 27.97±4.87N·m), reduced blood lactate (SMD, -0.2; 95% CI, -0.37 to -0.03; p=.272; decreasing 0.54±0.42mmol/L), decreased creatine kinase (SMD, -2.11; 95% CI, -2.57 to -1.65; p<.001; decreasing 160.07±27.96U/L), and reduced delayed-onset muscle soreness (SMD, -0.53; 95% CI, -0.81 to 0.24; p<.001). Using a 24-hour cutoff revealed 2 trends: treatment effectiveness depended on power and energy density, with optimal effects at 24.16 J/cm2 and 275 J/cm2 for energy, and 36.81 mW/cm2 and 5495 mW/cm2 for power. Noting that out of 21 studies, 19 are from Brazil, 1 from the United States, and 1 from Australia, and the results exhibit high heterogeneity.

CONCLUSIONS

Although we would have preferred a more geographic dispersion of laboratories, our findings indicate that near-infrared preirradiation mitigates peak torque decline in lower-limb muscles. Influenced by energy and power density with a 24-hour threshold, optimal energy and power densities are observed at 24.16 J/cm2, 275 J/cm2, 36.81 mW/cm2, and 5495 mW/cm2, respectively. Laser preirradiation also reduces blood lactate, creatine kinase, and delayed-onset muscle soreness.

Health status and heat preparation at a UCI World Tour multistage cycling race

OBJECTIVES

To assess health status and heat preparation of cyclists at the 2019 Tour Down Under and determine the alignment of heat mitigation strategies with current recommendations.

DESIGN

Cohort study.

METHODS

Twenty-three (17 % participation rate) male World Tour cyclists from five teams and 10 countries completed a pre-competition questionnaire evaluating exertional heat illness (EHI) history, pre-race health status, and heat mitigation and recovery strategies use. Associations between arrival days pre-competition, years as professional, nationality, team, history of EHI symptoms and diagnosis on heat mitigation and recovery strategy utilisation were assessed.

RESULTS

65 % of cyclists reported previously experiencing one or more EHI symptom (cramping: 48 %) and 22 % a diagnosis of heat stroke. In the 10 days preceding the race, 26 % experienced one or more illness symptoms. 65 % trained in the heat (acclimatisation 8-25 days; acclimation: 3-7 days), which was associated with team (P = 0.047, ϕc = 0.61), nationality (P = 0.009, ϕc = 0.86) and EHI symptoms history (P = 0.058, ϕ = 0.43). All cyclists had a hydration plan, with links to team (0.5-1.0 L·h-1, P = 0.043, ϕc = 0.68) and EHI symptom history (1.0-1.5 L·h-1, P = 0.048, ϕ = 0.476). Most had pre-cooling (87 %) and mid-cooling (83 %) strategies, most commonly cold beverages (75 %) and neck collars (78 %), respectively. All cyclists planned on using at least one recovery strategy (massage: 87 %).

CONCLUSIONS

Our data indicate good alignment with current recommendations for competing in the heat, particularly for hydration, cooling and recovery strategies. Whilst the proportion of cyclists engaging in heat acclimation/acclimatisation is encouraging, greater awareness on adapting and implementing heat training is required.

Effectiveness of abdominal massage on chronic constipation in adults: A systematic review and meta-analysis

BACKGROUND

Chronic constipation is a common distressing symptom. Abdominal massage is a safe, noninvasive, and comfortable intervention. However, it is rarely used in formal clinical practice as its' effectiveness for chronic constipation remains unclear.

OBJECTIVE

This systematic review aimed to investigate the effectiveness of abdominal massage on defecation frequency, stool consistency, colonic transit time, constipation symptoms, quality of life, laxative use, and adverse events in adults. Additionally, we aimed to compare the effectiveness of abdominal massage in chronic constipation with different etiologies and types of abdominal massage techniques.

METHODS

Data from eight English and Chinese electronic databases until May 15, 2024, including randomized controlled trials (RCT) and quasi-experimental studies, were used. The risk of bias was assessed using the Cochrane risk-of-bias tool. Results were synthesized using a random-effect model. This study was registered on the 7th of January 2023 to the International Prospective Register of Systematic Reviews (PROSPERO, CRD42023385243).

RESULTS

A total of 23 studies with 1431 participants were eligible for the meta-analysis. Abdominal massage statistically significantly increased weekly defecation frequency (MD = 1.59; 95 % CI 1.06, 2.11; df = 10; I2 = 82 %), decreased gut transit time (MD = -21.53 h; 95 % CI -35.94, -7.12; df = 3; I2 = 65 %), and decreased constipation symptoms (SMD = -1.06; 95 % CI -1.33, -0.80; df = 18; I2 = 79 %) as compared to the control group; however, it did not reduce laxative use (OR: 0.43, 95 % CI 0.14, 1.34, p = 0.15; I2 = 74 %). In subgroup analysis, the effectiveness of defecation frequency appeared to be greater for functional constipation (SMD = 1.23; 95 % CI 0.87, 1.60; df = 6; I2 = 86 %) as compared to opioid-induced constipation (SMD = 1.06; 95 % CI 0.61, 1.50; df = 5; I2 = 5 %) or neurogenic bowel dysfunction (SMD = 0.68; 95 % CI 0.26, 1.10; df = 4; I2 = 51 %). There were statistically significant differences in defecation frequency between the functional constipation and neurogenic bowel dysfunction groups (p = 0.075). Acupressure and aromatherapy massage had a greater effect on defecation frequency (SMD = 1.63; 95 % CI 1.06, 2.21; df = 3; I2 = 86 %) than circular massage (SMD = 0.90; 95 % CI 0.57, 1.22; df = 10; I2 = 68 %) or electric device massages (SMD = 0.83; 95 % CI 0.15, 1.51; df = 1; I2 = 82 %); however, high heterogeneity and a limited number of articles were encountered. No adverse reactions were observed in the non-neurogenic bowel dysfunction group.

CONCLUSION

This study reveals the efficacy of abdominal massage in alleviating symptoms of chronic constipation, as well as the differences in the effectiveness of different constipation types and massage techniques. Patients, caregivers, and health professionals can select abdominal massage techniques based on their effectiveness in specific type of constipation or troublesome symptoms.

TWEETABLE ABSTRACT

Abdominal massage is effective for chronic constipation, increasing defecation frequency and improving symptoms. Users can tailor massage technique to specific constipation type for optimal results. #ConstipationRelief #GutHealth.

Foam Rolling Intervention Improves Lactate Clearance After High-Intensity Exercise

The acute effects of a foam rolling intervention on lactate clearance and the impaired executive function associated with fatigue after high-intensity exercise remain unclear. This study examined whether foam rolling is an effective tool for fatigue recovery. Eighteen healthy adults without consistent exercise habits participated in this study. Participants performed high-intensity exercises, and the post-exercise foam rolling intervention was compared to the control condition. Measurements included lactate, vigor/fatigue by the Profile of Mood States 2nd Edition, cognitive function (cognitive task performance), leg and body rating of perceived exertion pre- and post-exercise, and post-intervention. Blood lactate concentrations post-foam rolling intervention (-7.3 ± 3.0 mmol/L) were significantly reduced among all participants. Increased lactate clearance by foam rolling correlated with a faster recovery of executive function for those with greater lactate clearance. However, cognitive fatigue was not observed after high-intensity exercise (p = 0.086, r = 0.41). Lactate clearance was not significantly correlated with the rating of perceived exertion in the foam rolling condition. The rating of the perceived exertion decreased with increased lactate clearance for those with greater lactate clearance in the control condition (leg: r = 0.778; body: r = 0.669). In conclusion, foam rolling intervention may be effective for exhausting exercise recovery.

Acute effect of myofascial stretching exercise on spasticity, balance, ambulation status and mobility of posterior chain muscles in multiple sclerosis

OBJECTIVE

To investigate the acute effect of myofascial stretching exercises on spasticity, balance, ambulation status and mobility of posterior chain muscles in multiple sclerosis.

METHOD

The study was conducted as a randomised controlled experimental study. The study included a total of 80 individuals diagnosed with multiple sclerosis (MS) with a mean age of 43.5 ± 9.62 years (experimental group) and 41.4 ± 10.4 years (control group). All individuals were treated once and evaluated before and after the session. After recording the sociodemographic characteristics, spasticity assessment was performed with the Modified Ashword Scale (MAS), balance assessment with the Berg Balance Scale (BBS), ambulation status with the Timed Up and Go Test (TUG), and posterior chain muscle mobility (PCMM) with finger-to-ground distance measurement.

RESULTS

The TUG (time to complete the distance) measurements of the experimental group after treatment were lower than those of the control group (p < 0.05). The value of PCMM measurements of the experimental group before the treatment was lower than that of the control group (p < 0.001). The difference in positive increase in PCMM measurements in the experimental group was higher than that in the control group (p < 0.05). After the treatment, the MAS value in the left knee of the experimental group was lower than that of the control group (p < 0.05).

DISCUSSION

Myofascial stretching exercises applied to individuals with MS made an acute contribution to ambulation status and mobility of posterior chain muscles. There was no difference in the evaluation of spasticity and balance.

Active versus passive foam rolling on range of motion, tissue property, and neural adaptation in healthy young adults: A randomised controlled trial

INTRODUCTION

Self-massage using a foam roller (foam rolling) is effective for increasing range of motion (ROM). However, the independent effects of pressure stimulation and voluntary movement during foam rolling remain unclear. This study investigated the effects of pressure stimulation and voluntary movement during the foam rolling intervention on ROM and its related parameters from the aspects of tissue mechanical properties and the central nervous system.

METHODS

This study set a randomised open-label controlled parallel group design involving active foam rolling with pressure stimulation and voluntary movement (A-FR), passive foam rolling with only pressure stimulation (P-FR), and sham rolling with only voluntary movement (SHAM) of the calf muscle. Twenty-seven healthy active adults (males: 16, females: 11) were analysed. Parameters of tissue mechanical properties (as measured by tissue stiffness and thickness) and systemic nervous adaptation (as measured by PPT, stretch tolerance, HRV, and mood states), as well as maximal ankle active/passive dorsiflexion ROM, were measured.

RESULTS

A-FR significantly improved pressure pain threshold, stretch tolerance, and negative mood and increased active and passive ROM. P-FR significantly improved parasympathetic nervous activity and negative mood and increased passive ROM. However, SHAM did not affect any ROM or parameters of tissue mechanical properties and systemic neural adaptation except for some negative mood improvement.

CONCLUSION

Voluntary movement does not independently affect ROM, whereas pressure simulation independently enhances ROM during the foam rolling intervention. Combining pressure stimulation and voluntary movement can enhance the ROM effect and influence parameters of tissue mechanical properties and the central nervous system.

Preventive effect of foam rolling on muscle soreness after exercise: A systematic review and meta-analysis

OBJECTIVE

This systematic review and meta-analysis aimed to evaluate the effect of foam rolling (FR) on exercise-induced muscle soreness.

METHODS

PubMed, EMBASE, Web of Science, ProQuest, Cochrane Library and China National Knowledge databases were searched to identify randomized controlled trials (RCTs) of the effect of FR intervening muscle soreness after exercise, from their inception to August 2022. The outcome indicators were visual analogue scale (VAS) and pressure-pain threshold (PPT).

RESULTS

A total of 16 studies were included, involving 515 subjects. Meta-analysis results show that FR has a certain effect of elimination of muscle soreness after exercise. The standard mean deviation (SMD) and 95% confidence interval (95%CI) of VAS and PPT immediately after intervention, 24, 48 and 72 h: [SMD = -0.38, 95%CI (-0.61, -0.15), P = 0.001], [SMD = -0.53, 95%CI (-0.82, -0.25), P = 0.0003], [SMD = -0.77, 95%CI (-1.12, -0.42), P < 0.00001], [SMD = -0.67, 95%CI (-1.09, -0.24), P = 0.002], [SMD = 0.23, 95%CI (0.62, 0.16), P = 0.25], [SMD = 0.48, 95%CI (0.11, 1.07), P = 0.11], [SMD = 0.39, 95%CI (-0.24, 1.02), P = 0.22], [SMD = 0.37, 95%CI (0.01, 0.74), P = 0.04].

CONCLUSION

Using foam rolling after exercise has a certain preventive effect on muscle soreness. Our study found that the effect of intervention of FR immediately is tiny after exercise, while the effective of intervening is relative obvious above 24 h.

REGISTRATION

PROSPERO (registration number: CRD42021250174).

A Randomized Controlled Trial to Compare the Effectiveness of Smart Dynamic Fabric Actuator with Exercises in Chronic Musculoskeletal Leg Pain Associated with Prolonged Standing in a Hospital Setting

Background

There are adverse effects on the health outcomes of workers whose occupation involves prolonged standing, such as lower back pain, leg pain, cardiovascular diseases, fatigue, discomfort, and pregnancy-related health outcomes. The effectiveness of massage therapy as an intervention for managing leg pain associated with prolonged standing needs to be addressed.

Aims

This study aimed to evaluate the smart dynamic fabric actuator's effectiveness in treating chronic musculoskeletal leg pain in persons with occupations involving prolonged standing.

Setting

Tertiary care hospital.

Design

Randomized controlled trial.

Methods

Thirty participants with chronic leg pain satisfying the inclusion and exclusion criteria participated in the study. The intervention group used the device for 15 minutes for each leg once a day and stretching exercises twice a day for six weeks. The control group performed stretching exercises twice a day for six weeks. The outcome was assessed at baseline, three weeks, and six weeks with a Numeric Rating Scale for pain and fatigue, short form-McGill Pain Questionnaire for pain, and SF-36 for quality of life.

Statistical Analysis

The groups were compared using the two-sample t-test with equal variances, the two-sample Wilcoxon rank-sum test, and the Chi2 exact test as appropriate.

Results

Thirty medical (nursing officers and doctors) and nonmedical professionals (security guards and sales assistants) with a mean age of 32.9 ± 5.6 years (intervention group) and 36.2 ± 5.1 years (control group) participated in the study. At six weeks, a significant improvement in pain (4.80 ± 1.14 to 1.66 ± 1.04 vs 4.66 ± 0.89 to 2.6 ± 0.91, P = 0.014), quality of life (58.77 ± 9.06 to 71.76 ± 8.43 vs 51.39 ± 8.26 to 63.87 ± 7.61, P = 0.012), and reduced fatigue (5 to 2 vs 5 to 3, P = 0.003) was observed in the intervention group when compared with the control group. No adverse events were observed.

Conclusion

A smart dynamic fabric actuator can be used as an adjunct to exercises for reducing leg pain and fatigue associated with prolonged standing.

Impact of a 5-min massage session on the gastrocnemius contractile and passive mechanical properties in young adults - A randomized controlled trial

The analysis of the impact of a 5-min massage session on the gastrocnemius contractile and passive mechanical properties in young adults - a randomized controlled trial.

BACKGROUND

The effect of massage therapy on the muscle properties is unclear. New technologies make investigation more in-depth and reliable.

OBJECTIVES

This study examined the effects of a 5-min massage session on the muscle stiffness and tone reduction in healthy young adults.

MATERIALS AND METHODS

Participants aged between 19 and 24 were randomly assigned to an intervention group (IG) (n = 40) or a control group (CG) (n = 40). The IG participated in a 5-min massage session of the lateral and medial gastrocnemius muscle (LGCM and MGCM respectively). The muscle contractile properties were assessed by tensiomyography (TMG). It measured maximal displacement (Dm), delay time (Td) and contraction time (Tc). Oscillation frequency (F) and stiffness (S) were used to assess muscle passive mechanical properties. These measurements were collected by MytonPro.

RESULTS

There were no differences between the groups in the pre-test measurements. The results of mixed-model ANOVA showed significant (p < 0.05) time × group interactions, with greater alteration in the IG compared to the CG in the LGCM for Dm (%diff = 22.5, ƞp2 = 0.41), Td (%diff = 3.63, ƞp2 = 0.02), Tc (%diff = 13.38, ƞp2 = 0.1), F (%diff = 5.55, ƞp2 = 0.07) and in the MGCM for Dm (%diff = -14.34, ƞp2 = 0.06), F (%diff = -7.53, ƞp2 = 0.12). No difference (p > 0.05) was noticed in other variables.

CONCLUSIONS

A 5-min massage session impacts the contractile and passive mechanical properties of the LGCM and MGCM. The size and direction of changes may depend on the muscle type, its geometry as well as other factors.

Comparison of the effects of cold water immersion and percussive massage on the recovery after exhausting eccentric exercise: A three-armed randomized controlled trial

Introduction

Athletic training requires both challenging stimuli for adaptation and sufficient recovery for improved performance. While cold water immersion (CWI) is already a popular recovery method, handheld percussive massage (PM) devices have also gained popularity in recent years. This study aims to assess the effects of CWI and PM on performance recovery after strenuous eccentric exercises compared to a passive rest (PR) control condition.

Methods

Thirty-four healthy physically active participants (9 females, 25 males) were randomly divided into three groups: CWI (n = 11), PM (n = 11), and passive rest (PR) (n = 12). They underwent an exhausting eccentric exercise protocol and different measurements at six time points (baseline, POST1, POST2, POST24, POST48, and POST72) over the time course of 72 h. These included subjective assessments of muscle soreness and perceived stiffness as well as measures of skin temperature, leg volume, creatine kinase activity, and three different jump tests. The eccentric exercise protocol consisted of 15 min downhill running (slope: 12%, speed: 10 km/h) and 3 sets of successive depth jumps (dropping height: 0.5 m) until individual exhaustion. After POST1 measurements, participants received 12 min of either CWI (11 ± 0.5°C), PM (40 Hz) or PR (supine posture).

Results

No significant group effects were found for the number of depth jumps performed during the exhaustion protocol. All jump tests displayed a significant group × time interaction effect. Post-hoc analysis indicated significant lower jump heights in ΔPOST2 between CWI and both PM and PR. No other significant group effects were observed at any time point. No significant group × time interaction effects were noted for CK, leg volume, and soreness. The perceived stiffness showed a significant group × time interaction effect. Post-hoc analysis revealed a significant decrease in stiffness for PM compared to PR at ΔPOST2.

Conclusion

Neither CWI nor PM showed any significant improvement in performance recovery over the 72-h period following strenuous eccentric exercise compared to PR. CWI showed an immediate performance decline which may be attributed to a cold-related reduction in motor nerve conduction velocity.

Changes in BDNF Concentration in Men after Foam Roller Massage

Massage is one of the oldest forms of therapy practiced since ancient times. Nowadays, it is used in sports practice, recovery from injury, or supportive therapy for various conditions. The practice of massage uses a variety of instruments that facilitate massaging while relieving the stress on the masseur. One of them is a foam roller. Although roller massage is widely used, there are still no scientific studies describing the biological mechanisms of its effects on the body. The purpose of our study was to analyze the effect of roller massage on BDNF levels in men undergoing self-massage 4x/week/7 weeks. The control group consisted of men who did not perform self-massage. Before the test and after the first, third, fifth, and seventh weeks of self-massage, the study participants' blood was drawn, the serum BDNF was determined, and the results were subjected to analysis of variance by ANOVA test. After the first week of self-massage, an increase in BDNF concentration was observed in the self-massage group compared to the control group (p = 0.023). Similarly, changes were observed in week five (p = 0.044) and week seven (p = 0.046). In the massaged group, BDNF concentrations were significantly higher after the first week of self-massage compared to baseline. In the third week of the study, BDNF decreased to a value comparable to the baseline study, then increased significantly in the fifth and seventh weeks compared to the value recorded in the third week (p = 0.049 and p = 0.029). It was significantly higher in week seven compared to week five (p = 0.03). Higher concentrations of BDNF in subjects undergoing roller self-massage may be one of the biological mechanisms justifying the therapeutic effects of massage in both sports and clinical practice. Studies analyzing the stimulation of BDNF synthesis through various massage techniques should be performed on a larger group of healthy individuals, patients after trauma of multiple origins, and sick people with indications for therapeutic massage.

Stripping Massage and Literature Review in Post-Thoracoscopic Chest Pain Management

The aim of this randomized study was to investigate whether stripping massage (SM) of myofascial trigger points in the lower rhomboid muscle could alleviate chest pain in patients following thoracoscopic surgery. In addition, a literature review was conducted to assess the effectiveness of various pain management techniques. Sixty adult patients who reported a visual analog scale (VAS) score of 4 or higher were randomly assigned to receive conventional analgesics alone (conventional group) or combined with SM twice daily for 2 weeks (SM group). VAS scores and the use of additional analgesics were evaluated on postoperative days 1, 3, 7, 14, and 30. Using the PubMed and Cochrane Library databases, a review of current pain management techniques was carried out up to January 31, 2022. A subgroup analysis was also performed to examine the treatment effect during different surgical periods and techniques. Results showed that the SM group had significantly lower VAS scores on postoperative days 3, 7, 14, and 30 (p < 0.001), as well as a shorter hospitalization duration and reduced need for additional analgesics (p < 0.001). The literature review included a total of 20 studies (2,342 cases of chest pain relief after thoracoscopic surgery), which indicated that serratus anterior plane (SAP) blocks were commonly used as a perioperative approach to reduce pain and opioid consumption. SM and SAP can both serve as adjuvant treatments for chest pain in patients following thoracoscopic surgery, with SM being a safe and noninvasive pain control option after hospital discharge.

Recent trends in Tuina for chronic pain management: A bibliometric analysis and literature review

BACKGROUND

The utilization of Tuina as a therapeutic intervention for the management of chronic pain has experienced a gradually increase in its popularity, and the purpose of this bibliometric analysis is to offer a comprehensive understanding of the current state and frontier trends, as well as to provide recommendations for future research directions.

METHODS

Publications on Tuina for chronic pain published between 2004 and 2023 were retrieved from the Web of Science Core Collection (WoSCC). Microsoft Excel, CiteSpace, VOSViewer, and the R package "bibliometrix" were used to quantitatively analyse the annual publication volume, countries/regions, journals, institutions, cited references, authors, and keywords.

RESULTS

A total of 287 publications were retrieved. The number of annual publications on the use of Tuina for treating chronic pain has gradually increased. Most publications were published in China and the United States. Notably, the most productive institution and author were identified as Shanghai University of Traditional Chinese Medicine and Min Fang, respectively. Medicine ranked first as the most influential affiliate and most productive journal. These publications came from 1650 authors, among whom Edzard Ernst had the most co-citations. Keyword analysis revealed that the new research frontier was low back pain.

CONCLUSION

The utilization of Tuina for the treatment of chronic pain has been gaining increasing recognition. Acupuncture, randomised controlled trials, systematic reviews, etc. were the main research subjects. Furthermore, low back pain is the new research frontier. This study provides an in-depth perspective on Tuina for chronic pain, which provides valuable reference material for clinicians with insights of therapeutic strategy, educators with valuable topics, and researchers with new research directions.

The effect of a 5-week therapeutic massage on erector spinae and upper trapezius muscle stiffness as determined by shear-wave elastography: a randomized controlled trial

Introduction

Massage is an effective treatment for reducing pain, swelling, stiffness, and improving muscle mobility. Although self-reported benefits on muscle stiffness and pain are well-known, studies measuring muscle stiffness objectively are scarce.

Methods

A randomized controlled trial involving 30 recreationally active young women (22.3 ± 0.4 years) was conducted. The participants were randomly assigned to either the control group or the intervention group which received a series of five 30-min whole back therapeutic massage sessions over 5 weeks. Shear wave elastography was used to assess muscle stiffness (erector spinae (ESp) and upper trapezius (UT) muscles) before and after the intervention and at 3-week follow-up.

Results

For ESp, there was no statistically significant time × group interaction (F = 2.908; p = 0.063). However, there was a statistically significant and large time × group interaction for UT (F = 13.533; p = 0.006; η 2 = 0.19). Post-hoc testing for time indicated that the shear modulus in the intervention group was reduced at follow-up (p = 0.005; d = 1.02), while the difference between baseline and post-intervention measurements were not statistically significant (p = 0.053; d = 0.75).

Conclusion

In conclusion, massage significantly reduced proximal UT stiffness both 3 days and 3 weeks after the intervention. However, it had no significant effect on the distal part of UT or the ESp muscle.

Effect of Single Session of Swedish Massage on Circulating Levels of Interleukin-6 and Insulin-like Growth Factor 1

Massage therapy increases muscle blood flow and heat, relieving pain, improving immune function, and increasing vagal activity. The mechanisms are unclear. Muscles release cytokines and other peptides called myokines. These myokines exert their effects on different tissues and organs in para-, auto-, and endocrine fashion. The aim of this intervention study was to investigate if massage therapy affects circulating myokine levels. A total of 46 healthy, normal-weight subjects (15 men) aged 18-35 were recruited. Forty-five minutes of massage Swedish therapy was applied to the back and hamstrings. Blood samples via cannula were taken at the baseline, during the massage (30 min), end of the massage (45 min), and 30 min and 1 h after the massage. Interleukin 6 (IL-6) and insulin-like growth factor 1 (IGF-1) were measured as surrogate markers by ELISAs. There was a significant increase in IL-6 from 1.09 pg/mL to 1.85 pg/mL over time (Wilks' Lambda Value 0.545, p < 0.000; repeated measures ANOVA). Pair-wise comparisons showed a significant increase after 1 h of massage. No significant increase was observed in IGF-1 levels. The change in myokine levels was not correlated with muscle mass (p = 0.16, 0.74). The increase in IL-6 suggests that there might be anti-inflammatory effects, affecting glucose and lipid metabolism pathways via IL-6 signaling to muscles, fat tissue, and the liver.

A comparison of dynamic warm-up and "warm-up" using self-massage tools on subsequent sit-and-reach displacement

OBJECTIVES

A dynamic warm-up (DWU) comprising exercise involving rhythmic muscle actions results in an acute increase in range of motion; however, recent findings suggest that a passive one using self-massage techniques might elicit a similar effect. This study's purpose was to compare the acute effect of leg cycling DWU on sit-and-reach score to the effect of a preparatory regimen of foam rolling (FR) or percussive massage (PM).

DESIGN

Single-blind, randomized, repeated-measures crossover study.

METHODS

Thirty-two asymptomatic, physically-active participants (male; n = 17) aged 20.9 ± 1.5 years performed sit-and-reach tests before, immediately following and 10-, 20- and 30-minutes following eight minutes of each of the "warm-ups." Analyses of variance at each time point across conditions and for the percent change elicited by each intervention were conducted to determine significant differences (p < 0.05).

RESULTS

Repeated-measures ANOVA revealed a significant difference between mean percent difference of sit-and-reach score for FR (8.8 ± 0.5%) compared to DWU and PM (p = 0.046 and 0.048, respectively) while DWU (6.3 ± 0.8%) and PM (6.8 ± 0.5%) did not differ (p = 0.717). There were no differences between scores across interventions at any of the four time points.

CONCLUSIONS

A bout of FR or PM resulted in an acute increase in a sit-and-reach score during a test performed immediately post and at 10-, 20- and 30-minutes post that was similar in magnitude to that which was present following leg cycling. These passive "warm-ups" are appropriate alternate strategies that can be employed to improve performance on a sit-and-reach test.

Acute Effects of Handheld Vibration Massage on Posterior Shoulder Soft Tissues

Background

Interventions using vibration stimulation have been recognized for their potential for increasing range of motion (ROM) without compromising muscle strength. Handheld vibration massagers can efficiently deliver vibration therapy to the shoulder joint and may be a potential treatment.

Purpose

To evaluate the effects of vibration massage using a handheld device on the soft tissues of the posterior shoulder joint, particularly on internal rotation (IR) passive ROM and external rotation (ER) muscle strength.

Study Design

Crossover study design.

Methods

A crossover study with a 5-min vibration massage and passive control condition was conducted in healthy male volunteers (mean age 20.5 ± 1.7 years). Vibration massage was applied to the posterior shoulder soft tissues of the dominant arm, with no intervention under control conditions. IR-ROM (vertebral level and in abduction) and strength of the external rotators (isometric and isokinetic) were measured before and immediately after the intervention. Vertebral levels were calculated as a ratio of lengths (ratio decreases with increased mobility). IR-ROM in abduction, the angle was measured. Statistical analysis was performed with two-way repeated measures ANOVA and paired t-test (Bonferroni correction).

Results

Vibration application decreased (improved) vertebral level IR ROM by -4.1% (p < 0.01, d = 0.445) and increased abduction position IR ROM by 11.4° (p < 0.01, d = 0.694). These changes exceeded the 95% confidence interval for the minimum detectable change. By contrast, the control condition produced no changes. IR-ROM (vertebral level and abduction) immediately after the intervention showed significant differences between the control and vibration conditions (p = 0.036, d = 0.273; p = 0.048, d = 0.483, respectively). Muscle strength did not show any interaction, time, or between-condition effects.

Conclusions

A massage using a handheld vibration massager applied to the posterior shoulder soft tissues increased IR-ROM without negatively affecting muscle strength, suggesting its potential use as a means of warming up.

Level of Evidence

Level 3.

Effectiveness of the Cunningham technique for shoulder dislocation reduction and its role in providing analgesia and muscle relaxation as an adjunctive method

BACKGROUND

Shoulder dislocation, particularly anterior dislocation, is a common orthopedic injury often presenting in emergency care settings, characterized by significant pain and muscle spasms. Prompt reduction is essential to alleviate symptoms and restore function. The Cunningham technique employs gentle pulling and massage motions targeted at the muscles and has emerged as a promising method for reducing anterior shoulder dislocations. However, its reported success rates vary widely across studies, and questions remain regarding its efficacy, particularly in cases of failure. This study aims to evaluate the effectiveness of the Cunningham technique for reducing anterior shoulder dislocations and its potential role in providing analgesia and muscle relaxation as an adjunctive method.

METHODS

A retrospective study was conducted on patients presenting with acute anterior shoulder dislocation at a single center. Reduction using the Cunningham technique was performed initially, followed by the external rotation technique if unsuccessful. Procedural sedation and analgesia were administered if the reduction was still not achieved, and shoulder dislocation reduction was performed again through the external rotation method. The patients' VAS scores were recorded and evaluated the Cunningham technique's effectiveness in reduction and whether it increases the effectiveness of other techniques applied for reduction by lowering the VAS score, even in cases where it is not effective.

RESULTS

A total of 61 patients were included in the study. The reduction was performed using the Cunningham technique in 34.4% (21/61) patients, the external rotation technique in 47.5% (29/61) patients, and the external rotation technique with PSA in 18% (11/61) patients. Significant differences were observed in the duration of hospital stay among the three techniques, with ER with PSA resulting in the longest stay. VAS scores showed significant improvements from initial presentation to post-reduction in all three groups. A significant decrease in pre-reduction VAS scores was observed during the transition from the Cunningham technique to other techniques.

CONCLUSION

The Cunningham technique showed effectiveness in reducing anterior shoulder dislocations, providing analgesia, and muscle relaxation. It demonstrated favorable outcomes as an initial reduction technique, with the external rotation technique used as a subsequent option. Further studies comparing the success rates and complications of the Cunningham technique with other reduction methods are warranted to establish its role in clinical practice.

Recovery effect of self-myofascial release treatment using different type of a foam rollers

Among athletes, foam rolling is popular technique of myofascial release aimed to support recovery processes and counteract delayed onset muscle soreness. However, there is no consensus on the optimal parameters of the roller texture used in the procedure. The study aimed to determine whether using rollers with different textures and hardness (smooth/soft, grooved/mid, serrated/hard) in myofascial release affects post-exertional restitution rate and the level of perceived DOMS (Delayed Onset Muscle Soreness) after intense anaerobic exercise. The study involved 60 healthy and physically active men randomly divided into three experimental groups and one control group (passive rest)-each consisting of 15 individuals: STH-rolling with a smooth roller; G-rolling with a grooved roller; TP-rolling with a serrated roller; Pass-passive rest group. After performing a exercise test (one-minute high-intensity squat), blood lactate (LA), creatine kinase (CK) and pain perception (VAS Scale) were monitored. The analysis of the average LA concentration in the blood 30 min post-exercise showed a statistical difference for all rolling groups compared to the passive rest group: STH (p < 0.001), G (p < 0.001), TP (p = 0.035). No statistically significant differences were found between the CK measurement results in individual assessments. Statistically significant differences in VAS values were observed between G (p = 0.013) and TP (p = 0.006) groups and the Pass group at 48 h, as well as between STH (p = 0.003); G (p = 0.001); TP (p < 0.001) groups and the Pass group at 72 h. Based on statistical data, a strong influence (η2 = 0.578) of time on the quadriceps VAS variable was noted. The research results confirm the effectiveness of rolling in supporting immediate and prolonged recovery. The conducted studies indicate a significantly better pace of post-exertional recovery after a rolling procedure lasting at least 120 s. The texture and hardness of the tool used did not matter with such a duration of the treatment.

Relationship between changes in muscle stiffness after a comfortable massage and the massage pressure

INTRODUCTION

This study aimed to determine whether massage pressure on the target muscles (biceps brachii muscle [BB] and the medial head of the gastrocnemius muscle [MG]) is related to the massage effect (reducing muscle stiffness).

METHOD

Nine healthy participants participated in this study. A physiotherapist massaged the upper arms and lower legs of participants on a rigid desk in a laboratory. Massage was delivered for 10 min with a 3-min rest. The shear modulus (i.e., the muscle stiffness), assessed by shear wave elastography, was measured at various time points (before [PRE], immediately after [POST], and 5 [POST-5], 10, 15, and 20 min after the massage). The massage pressure data (N) were obtained only during massage by force plate sensors.

RESULTS

The BB shear modulus was significantly reduced POST massage. The MG shear modulus significantly reduced POST massage and remained clearly reduced until POST-5. There was a negative correlation between the total massage pressure and the % change in the shear modulus in both muscles.

DISCUSSION

Since the spindle (BB) and pennate (MG) muscles have structural differences, our results suggest that these differences may affect the pattern of changes in the shear modulus in response to massage.

CONCLUSION

Massage pressure is related to the massage effect (reducing muscle stiffness), and its relationships to POST are not related to the differences in the morphologies of the spindle (BB) and pennate muscles (MG). However, differences in the morphologies of the spindle and pennate muscles may cause differences in the duration of the massage effects.

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

BACKGROUND

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

HYPOTHESIS

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

STUDY DESIGN

Single-blind randomized crossover trial.

LEVEL OF EVIDENCE

Level 2.

METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL RELEVANCE

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

Utilization of massage chairs for promoting overall health and wellness: A rapid scoping review

OBJECTIVE

To investigate the potential benefits of using massage chairs for improving health.

DATA SOURCES

A rapid scoping review was conducted using PubMed, Embase, Cochrane Library, and Google Scholar from inception to November 1, 2022.

STUDY SELECTION

Using the keyword strategy ("massage chair*" OR "massage-chair*"), only studies in English were selected. Two reviewers independently screened the studies, and conflicts were resolved by consensus. Studies involving physical massage therapy were excluded.

DATA EXTRACTION

A total of 59 articles were identified, and 18 were included in the final analysis. Quality assessment was performed, following STROBE, CONSORT and CASP guidelines. The following data were extracted: authors, year, country, study design, study objective, age, gender, participants, measures, and main findings.

DATA SYNTHESIS

The results of the present review indication that the utilization of massage chairs may positively affect both physical and mental health concerns. This review especially found a more significant number of studies showing benefits in mental health. However, two case reports indicated complications when using massage chairs.

CONCLUSIONS

The use of massage chairs could have benefits on cognitive function improvement, stress reduction and mental fatigue decline, muscle stiffness improvement, pain reduction, and potential benefits for quality of life.

Acute Effects of Local High-Frequency Percussive Massage on Deep Fascial and Muscular Stiffness and Joint Range of Motion in Young Adult Men

BACKGROUND

Local high-frequency percussive (HFP) massage has recently found widespread application in physical therapy. Although HFP massage reportedly improves range of motion (ROM), the mechanism underlying its action has not yet been proven. This study aimed to clarify whether a 5-minute percussive massage regimen affects muscular or connective tissues, such as the deep fascia and deep intermuscular fascia and the change in joint ROM.

METHOD

The study sample was calculated using G*Power analysis program, and this study enrolled 15 healthy men who underwent 5-minute HFP massage to the medial gastrocnemius muscle. Shear-wave elastography was used to measure tissue stiffness in the deep fascia, muscle, and deep intermuscular fascia through shear-wave velocity as well as the ROM of the volunteers' ankle joint dorsiflexion before and after the HFP massage. A value of P < .05 was used to declare statistical significance, and post hoc was used to calculate the effect size using G*Power.

RESULTS

Shear-wave velocity revealed a significant change in the deep fascia (P = .003; shear-wave velocity: -0.7 m/s) and significant increase in ROM of ankle dorsiflexion (P = .002; increase in ROM: 3.0°) after 5 minutes of HFP massage. However, the muscle and deep intermuscular fascia did not exhibit any significant changes.

CONCLUSIONS

HFP massage for 5 minutes modified the stiffness of the deep fascia and concurrently improved the ankle joint-dorsiflexion ROM. This method can be used as an intervention to decrease stiffness of the deep fascia and increase the ROM efficiently.

General Treatments Promoting Independent Living in Parkinson's Patients and Physical Therapy Approaches for Improving Gait-A Comprehensive Review

This study delves into the multifaceted approaches to treating Parkinson's disease (PD), a neurodegenerative disorder primarily affecting motor function but also manifesting in a variety of symptoms that vary greatly among individuals. The complexity of PD symptoms necessitates a comprehensive treatment strategy that integrates surgical interventions, pharmacotherapy, and physical therapy to tailor to the unique needs of each patient. Surgical options, such as deep brain stimulation (DBS), have been pivotal for patients not responding adequately to medication, offering significant symptom relief. Pharmacotherapy remains a cornerstone of PD management, utilizing drugs like levodopa, dopamine agonists, and others to manage symptoms and, in some cases, slow down disease progression. However, these treatments often lead to complications over time, such as motor fluctuations and dyskinesias, highlighting the need for precise dosage adjustments and sometimes combination therapies to optimize patient outcomes. Physical therapy plays a critical role in addressing the motor symptoms of PD, including bradykinesia, muscle rigidity, tremors, postural instability, and akinesia. PT techniques are tailored to improve mobility, balance, strength, and overall quality of life. Strategies such as gait and balance training, strengthening exercises, stretching, and functional training are employed to mitigate symptoms and enhance functional independence. Specialized approaches like proprioceptive neuromuscular facilitation (PNF), the Bobath concept, and the use of assistive devices are also integral to the rehabilitation process, aimed at improving patients' ability to perform daily activities and reducing the risk of falls. Innovations in technology have introduced robotic-assisted gait training (RAGT) and other assistive devices, offering new possibilities for patient care. These tools provide targeted support and feedback, allowing for more intensive and personalized rehabilitation sessions. Despite these advancements, high costs and accessibility issues remain challenges that need addressing. The inclusion of exercise and activity beyond structured PT sessions is encouraged, with evidence suggesting that regular physical activity can have neuroprotective effects, potentially slowing disease progression. Activities such as treadmill walking, cycling, and aquatic exercises not only improve physical symptoms but also contribute to emotional well-being and social interactions. In conclusion, treating PD requires a holistic approach that combines medical, surgical, and therapeutic strategies. While there is no cure, the goal is to maximize patients' functional abilities and quality of life through personalized treatment plans. This integrated approach, along with ongoing research and development of new therapies, offers hope for improving the management of PD and the lives of those affected by this challenging disease.

Tactile, Auditory, and Visual Stimulation as Sensory Enrichment for Dairy Cattle

Several types of enrichment can be used to improve animal welfare. This review summarizes the literature on the use of mechanical brushes, tactile udder stimulation, music, and visual stimuli as enrichment methods for dairy cows. Mechanical brushes and tactile stimulation of the udder have been shown to have a positive effect on milk yield and overall behavioral repertoire, enhancing natural behavior. Classical music reduces stress levels and has similarly been associated with increased milk yield. A slow or moderate tempo (70 to 100 bpm) at frequencies below 70 dB is recommended to have this positive effect. Evidence on the impacts of other types of enrichment, such as visual stimulation through mirrors, pictures, and color lights, or the use of olfactory stimuli, is equivocal and requires further study.

Effects of different treatments on pain, functional disability, position sense and range of motion in elite bodybuilders with chronic low back pain

Back pain is one of the major global challenges and is one of the most prevalent musculoskeletal disorders occurring in 80% of people at least once in their lifetime. Therefore, the need to find appropriate treatment methods for this issue is very important. The objective is to examine the short-term and acute effects of a treatment session with dry needling, massage therapy, stretching exercises and Kinesio tape on pain, functional disability, position sense and range of motion in elite bodybuilders with non-specific chronic low back pain. The sample of this quasi-experimental study consisted of 48 bodybuilders with non-specific chronic low back pain (all male, mean age = 25.96 ± 2.18 years; mean weight = 74.45 ± 4.51 kg; mean height = 173.88 ± 3.74 cm; mean BMI = 24.60 ± 0.74 kg/m2) who randomly were placed in 4 dry needling, massage therapy, stretching exercises and Kinesio tape groups. The duration of each intervention was 30 min. The dependent variables in this study included the massage range of motion, position sense tests and visual pain scale that were taken separately from each subject in pretest, posttest (acute effect) and follow-up test (72 h after posttest; short-term effect). The results of a 4 (groups) × 3 (time) the mixed ANOVAs showed that pain in the short-term phase was significantly lower in the dry needling group than in the stretching and massage groups (P < 0.05). Also in the acute effect phase, the flexion range of motion was significantly lower in the dry needling group than in the massage group (P < 0.05). Furthermore, the two groups of stretching and massage exercises showed significantly greater range of motion (P < 0.05). Other comparisons were not significant (P > 0.05). The findings of the study showed that both massage and stretching treatment have higher acute effects, while dry needling treatment was more effective in follow up. On the other hand, these findings show that these treatment methods can have immediate and lasting positive effects in improving the performance in elite bodybuilders with non-specific chronic low back pain.

Efficacy of Dashmool Vasti as an adjuvant therapy with the standard of care (modern + physiotherapy) in the rehabilitation of stroke as compared to standard of care - a clinical trial protocol

Background

Stroke is ischemia and neurological dysfunction caused by acute brain circulation loss. It causes acute localized neurological abnormalities such as weakness, sensory deficit, or language issues that require long-term treatment. These deficiencies harm the patient and their family psychologically, socially, and economically. Thus, combination treatment can rapidly rehabilitate such patients. Detoxification methods like Ayurvedic medicated enema help stroke pathophysiology. Physical modalities in physiotherapy have been shown to facilitate normal movement and function on the stroke patient's affected side, increasing independence with everyday duties. A stroke patient may benefit from Dashmoola Niruha Basti, Function Electrical Stimulation (FES), and Motor Relearning Programme (MRP).

Aim & Objectives

This study compares the adjuvant role of Dashmoola Basti with MRP and FES in stroke recovery. The main goals of this study are to assess and compare the adjuvant role of Dashmoola Basti with standard control over sensorimotor function of lower extremities, static and dynamic balance in stroke patients; gait parameters; resistance experienced during passive range of motion; quality of life of patients; Barthel Index; Modified Ashworth Scale; and Fuglmeyer assessment, Single Limb Stance Test, Functional Reach Test.

Methods

A total of 40 patients will be enrolled and divided randomly into two equal groups. In Group A (control), standard treatment (modern + physiotherapy) will be prescribed for one month. In Group B (interventional group), Dashmoola Basti will be added to the aforementioned standard treatment for one month.

Expected results

Improvement in Fuglmeyer assessment, Single Limb Stance Test, Functional Reach Test, quality of Life of Patients, Barthel Index, Modified Ashworth scale, and National Institute of Health (NIH) stroke-scale-score will be observed and recorded.

Conclusions

Results and conclusions will be derived according to the data collected in case record form and assessment sheets filled at baseline and follow-up visits.

Trial registration

CTRI/2021/10/037445 dated 21.10.2021.

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.

Local alternating heat and cold stimulation affects hemodynamics and oxygenation in fatigued muscle tissue and autonomic nervous activity: a single-arm interventional study

BACKGROUND

Local alternating heat and cold stimulation as an alternative to contrast bath may cause intermittent vasoconstriction and vasodilation, inducing a vascular pumping effect and consequently promoting increased tissue blood flow and oxygenation. This study aimed to examine the effects of local alternating heat and cold stimulation, using a wearable thermal device, on the hemodynamics of fatigued muscle tissue and autonomic nervous activity.

METHODS

Twenty healthy individuals experienced fatigue in the periarticular muscles of the shoulder joint due to a typing task. Local alternating heat and cold stimulations were then applied to the upper trapezius muscle. Muscle hardness was measured using a muscle hardness meter, and muscle tissue hemodynamics and oxygenation were evaluated using near-infrared spectroscopy before and after the stimulation. Autonomic nervous activity was also evaluated using heart rate variability.

RESULTS

Alternating heat and cold stimulation decreased muscle hardness of the fatigued trapezius muscle from 1.38 ± 0.15 to 1.31 ± 0.14 N (P < 0.01). The concentration of total hemoglobin in the trapezius muscle tissue increased from - 0.21 ± 1.36 to 2.29 ± 3.42 µmol/l (P < 0.01), and the tissue hemoglobin oxygen saturation also increased from 70.1 ± 5.4 to 71.1 ± 6.0% (P < 0.05). Additionally, the heart rate variability parameter, which is an index of sympathetic nervous activity, increased from 3.82 ± 2.96 to 6.86 ± 3.49 (P < 0.01). A correlation was found between increased tissue hemoglobin oxygen saturation and increased parameters of sympathetic nervous activity (r = 0.50, P < 0.05).

CONCLUSIONS

Local alternating heat and cold stimulation affected the hemodynamic response in fatigued muscle tissue and autonomic nervous activity. This stimulation is more efficient than conventional contrast baths in terms of mobility and temperature control and has potential as a new versatile therapeutic intervention for muscle fatigue.

TRIAL REGISTRATION

UMIN-CTR (UMIN000040087: registered on April 7, 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045710 . UMIN000040620: registered on June 1, 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046359 ).

The effects of manual therapy in pain and safety of patients with knee osteoarthritis: a systematic review and meta-analysis

BACKGROUND

Manual therapy (MT) is frequently used in combination with management of osteoarthritis of the knee, but there is no consensus on the exact efficacy of this treatment strategy. The purpose of this systematic review and meta-analysis was to evaluate the pain relief and safety of MT for treatment of knee osteoarthritis (KOA).

METHODS

Randomized controlled trials evaluating MT in patients with KOA in major English and Chinese journals were searched in the following databases: Wanfang, China Science and Technology Journal Database (VIP database), China National Knowledge Infrastructure (CNKI), PubMed, Embase, Web of Science, and the Cochrane Library databases through June 2023. The methodological quality and quality of evidence of the included studies were assessed using Cochrane's risk-of-bias 2 (ROB 2) tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Data analysis was performed using Stata version 15.0 software. After use of Galbraith plots to exclude studies that could lead to heterogeneity, random effects models were used to analyze the remaining data and test the consistency of the findings. We used meta-regression to assess the effect of treatment period, patient age, and sex ratio on outcomes. Funnel plots and Egger's test were used to evaluate publication bias. Sensitivity analyses were used to determine the reliability of the results.

RESULTS

A total of 25 studies, with 2376 participants, were included in this review. The overall methodological quality of the included studies was limited. Our findings suggest that MT has a positive impact on pain relief outcomes in KOA patients. The meta-analysis showed that MT was superior to usual care (SMD = 2.04, 95% CI 0.94, 3.14, I 2 = 96.3%; low evidence quality) and exercise (SMD = 1.56, 95% CI 0.41, 2.71, I 2 = 96.3%; low evidence quality) for reducing pain. In terms of improvement in visual analogue scale (VAS) scores, MT treatment beyond 4 weeks (SMD = 1.56, 95% CI 0.41, 2.71, I 2 = 96.3%) may be superior to treatments less than or equal to 4 weeks (SMD = 1.24, 95% CI 0.56, 1.95, I 2 = 94.7%). No serious adverse events associated with MT were reported.

CONCLUSIONS

MT may be effective at reducing pain in patients with KOA and may be more effective after a 4-week treatment period. Compared with usual care and exercise therapy, MT may be superior at reducing KOA pain in the short term (9 weeks), but its long-term efficacy requires careful consideration of evidence-based outcomes. MT appears to be safe for KOA patients, though clinicians should inform patients of the potential risk of MT-related adverse events.

Under the Gun: Percussive Massage Therapy and Physical and Perceptual Recovery in Active Adults

CONTEXT

Handheld percussive massage devices (ie, massage guns) are a relatively new and under-researched recovery tool. These tools are intended to increase range of motion and reduce muscle soreness by delivering targeted vibration to soft tissues. Empirical knowledge about the potential influence of these devices on perceptual recovery and the recovery of performance characteristics after exercise is scarce.

OBJECTIVE

To investigate the effect of a 5-minute massage gun application, using a commercially available device, on physical and perceptual recovery after a strenuous bout of lower body exercise.

DESIGN

Controlled laboratory study.

SETTING

Physiology laboratory.

PATIENTS OR OTHER PARTICIPANTS

A total of 65 active young adults (age = 21.3 ± 1.4 years; age range = 18-30 years; 34 women: height = 165.8 ± 6.1 cm, mass = 66.0 ± 7.4 kg; 31 men: height = 181.1 ± 6.0 cm, mass = 81.5 ± 11.8 kg).

INTERVENTION(S)

Participants applied a massage gun on the calf muscles of 1 leg after strenuous exercise (massage gun recovery group) for 5 minutes and used no recovery intervention on the other leg (control group).

MAIN OUTCOME MEASURE(S)

Ankle range of motion, calf circumference, isometric strength, calf endurance, and perceived muscle soreness measures were collected at baseline and at various points after lower body exercise.

RESULTS

No significant group × time interactions were recorded for any of the performance or perceptual measures (P values > .05). Effect sizes were mostly unclear, except for a small increase in perceived muscle soreness in the massage gun recovery group compared with the control group immediately (d = -0.35) and 4 hours (d = -0.48) postrecovery.

CONCLUSIONS

Massage guns appeared to have little effect on physical measures when applied for 5 minutes immediately after strenuous calf exercise. Given the small increase in muscle soreness up to 4 hours after their use, caution is recommended when using massage guns immediately after strenuous lower body exercise.

The Multisystem effects of Long COVID Syndrome and Potential Benefits of Massage Therapy in Long COVID Care

Background

A major complication of infection with Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, is the potential for Long COVID Syndrome. While the pathophysiology of Long COVID Syndrome has yet to be described, the disease presentation is characterized by long-term symptoms with debilitating effects on human health. A better understanding of Long COVID symptomology may open up new avenues for patient treatment such as massage therapy.

Methods

From the PubMed database, cohort studies that examined post-infection COVID sequelae published between January 1st, 2021 and April 30th, 2021 were selected to investigate patient demographics and symptoms. A review of massage therapy literature since 2000 in conjunction with identified Long COVID symptoms was performed.

Results

This systematic review identified 17 cohort studies across the world that investigated the symptomatology of patients suffering from post-COVID sequelae in multiple organ systems. We identified the pulmonary and nervous systems to be the organ systems most affected with post-COVID sequelae, with PTSD, fatigue, dyspnea, cough, sleep disturbances, loss of smell, abdominal pain, and decreased appetite as the most common symptoms reported by >20% of Long COVID patients. Massage therapy was historically found to provide benefits to patients experiencing similar symptoms to those identified in Long COVID.

Conclusions

Recognizing the need for new approaches to treatment for Long COVID Syndrome, we identify massage therapy as a potential therapeutic treatment to positively impact the organ systems affected by Long COVID, especially the high-incident symptoms, and improve patient quality of life.

Beyond the obvious: A case presentation on the misdiagnosis of posterior femoral cutaneous nerve entrapment as semitendinosus muscle tear

To underscore the importance of evaluating the entrapment of the posterior femoral cutaneous nerve (PFCN) in patients exhibiting symptoms in the posterior thigh region. A 42-year-old male dentist, initially diagnosed with a semitendinosus muscle tear and persistent pain and tingling in the posterior thigh, sought treatment at our outpatient clinic. Despite unsuccessful physiotherapy, a comprehensive evaluation revealed an unusual entrapment of the PFCN between the sacrotuberous ligament and the semitendinosus muscle stump. The patient was subjected to a series of specialized therapeutic interventions, including soft tissue release, kinesiology taping, and lifestyle modifications. The patient's symptoms, including pain and tingling, were completely resolved, enabling him to sit on a stool for extended periods without discomfort. This case presentation emphasizes the need for physical therapists to consider the possibility of PFCN entrapment in patients experiencing pain and tingling in the posterior thigh. These symptoms can be easily mistaken for conditions such as sciatica or a hamstring muscle tear.

Impact of warm-up methods on strength-speed for sprinters in athletics: a mini review

In athletics, achieving peak performance during competitions is crucial. Warm-up strategies play a crucial role in optimizing the strength-speed performance of sprinters in athletics, especially tailored to the physiological demands of speed events. The need to balance flexibility, prevent injuries, and enhance power output makes the selection of an effective warm-up protocol essential. This narrative review examines different warm-up methods used by athletes and their effects on strength-speed in sprinters in athletics. The main findings indicate that Foam Rolling (FR), Isometric Exercises and Pre-Competitive Massages have no significant effects on sprint performance. Static stretching and prolonged Pre-Competitive Massages have negative impacts on strength and power. The Vibration Platform enhances step length, step rate and running velocity, jump height and total number of jumps performed in a 30-s period in non-experienced sprinters. Eccentric Exercise increases vertical force, Post-Activation Potentiation (PAP) demonstrates a reduction in 100-meter time and short-term improvement in vertical and horizontal jumps. Blood Flow Restriction (BFR) significantly improving jump height and flight time. Various warm-up methods have been identified, some focusing on flexibility, others potentially detrimental, and some enhancing strength and power. Implementing effective warm-ups, particularly those promoting strength and power, poses a challenge for coaches seeking reliable alternatives to boost performance.

Effectiveness of massage and range of motion exercises on muscle strength and intensive care unit-acquired weakness in Iranian patients with COVID-19: a randomized parallel-controlled trial

BACKGROUND

Muscle weakness is prevalent in intensive care patients. This study focused on comparing the effects of massage and range of motion (ROM) exercises on muscle strength and intensive care unit-acquired weakness (ICU-AW) among patients with coronavirus disease 2019 (COVID-19).

METHODS

This study was a randomized clinical trial that recruited patients (n=45) with COVID-19 admitted to the ICU and divided them into three groups (ROM exercises, massage, and control). We evaluated muscle strength and ICU-AW in the arms and legs using a hand dynamometer. The Medical Research Council sum score was determined before and after the intervention.

RESULTS

The study findings were that 0%, 20%, and 100% of the participants in the ROM exercises, massage, and control groups had ICU-AW on the 7th day of ICU admission. The ROM exercise group had greater muscle strength in the hands and legs than the massage and control groups, and the massage group had greater muscle strength than the control group.

CONCLUSIONS

Massage and ROM exercises could improve muscle strength and reduce ICU-AW in COVID-19 patients admitted to the ICU.

Sensory Stimulation of the Triceps Surae Muscle Complex Modulates Spinal Reflex Responses-A Comparison between Tapotement Massage and Repetitive Peripheral Magnetic Stimulation (rPMS)

BACKGROUND

The reduction of muscular hypertonia is important in the treatment of various diseases or rehabilitation. This study aims to test the efficacy of a 5 Hz mechanical muscle stimulation (tapotement massage) in comparison to a 5 Hz repetitive peripheral magnetic stimulation (rPMS) on the neuromuscular reflex response.

METHODS

In a randomized control trial, 15 healthy volunteers were administered with either 5 Hz rPMS, tapotement massage, or rPMS sham stimulation. The posterior tibial nerve was stimulated with rPMS and sham stimulation. The Achilles tendon was exposed to a mechanically applied high-amplitude 5 Hz repetitive tendon tapotement massage (rTTM). The tendon reflex (TR) was measured for the spinal response of the soleus muscle.

RESULTS

After rPMS, there was a reduction of the TR response (-9.8%, p ≤ 0.034) with no significant changes after sham stimulation. Likewise, TR decreased significantly (-17.4%, p ≤ 0.002) after Achilles tendon tapotement intervention.

CONCLUSIONS

These findings support the hypothesis that both afferent 5 Hz sensory stimulations contributed to a modulation within the spinal and/or supraspinal circuits, which resulted in a reduction of the spinal reflex excitability. The effects could be beneficial for patients with muscle hypertonia and could improve the functional results of rehabilitation programs.