Does vibration benefit delayed-onset muscle soreness?: a meta-analysis and systematic review

The Effects of 2 Different Soft Tissue Mobilization Techniques on Delayed Onset Muscle Soreness in Male Recreational Athletes: A Single-Blinded Randomized Controlled Trial

CONTEXT

Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes.

DESIGN

A parallel, single-blinded, randomized controlled trial.

METHODS

Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups.

RESULTS

No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750).

CONCLUSIONS

Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes.

The Effect Of Percussive Therapy On Musculoskeletal Performance And Experiences Of Pain: A Systematic Literature Review

Background

There is a lack of specific research on the effect of percussive therapy (PT) delivered by massage guns on physiological adaptations. This systematic literature review investigates research conducted on the effects of PT interventions on performance in strength and conditioning settings, and on experiences of musculoskeletal pain.

Purpose

To determine the effect of PT delivered by massage guns on physiological adaptations: muscle strength, explosive muscle strength and flexibility, and experiences of musculoskeletal pain.

Study Design

Systematic literature review.

Methods

Data sources (CINAHL, Cochrane Library, Psychinfo, PubMed, SportDISCUS and OpenGrey) were searched from January 2006 onwards for full text literature in any language involving adult populations receiving PT delivered by massage guns, directly to any muscle belly or tendon, with comparisons to an alternative treatment, placebo or no treatment. Literature with outcomes relating to acute or chronic physiological adaptations in muscle strength, explosive muscle strength, flexibility or experiences of musculoskeletal pain were included. Articles were assessed for quality using the Critical Appraisal Skills Programme and PEDro scores.

Results

Thirteen studies met the inclusion criteria. All studies had limitations in methodological quality or reporting of findings but still included contextually-rich details that contributed to the overall narrative synthesis. A significant relationship was found between a single application of PT delivered by massage guns and an acute increase in muscle strength, explosive muscle strength and flexibility, with multiple treatments eliciting a reduction in experiences of musculoskeletal pain.

Conclusion

PT delivered by massage guns can help improve acute muscle strength, explosive muscle strength and flexibility, and reduce experiences of musculoskeletal pain. These devices may provide a portable and cost-effective alternative to other forms of vibration and interventions.

Effect of kinesio taping in combination with vibration treatment on college students' delayed-onset muscle soreness

Objective: Kinesio taping (KT) and vibration treatment (VT) can alleviate delayed-onset muscle soreness (DOMS) to some extent. However, the literature reports on the difference between the two treatments, and whether a joint intervention (JI) works better than single treatments remains unknown. This study compares the effects of KT, VT and JI on DOMS in college students. Methods: A total of 88 college students were randomly divided into the KT (KTG, n = 21), VT (VTG, n = 22), JI (JIG, n = 23) and control (CG, n = 22) groups. All subjects underwent DOMS moulding. The baseline; immediate and 24, 48 and 72 h visual analogue scale (VAS) scores and knee extensor maximum isometric voluntary contraction (MIVC) were determined. Results: The intergroup comparison showed the following results. 1) The VAS scores of the four groups peaked at 24 h and gradually decreased. The immediate, 24 h and 48 h VAS scores followed the order: JIG > KTG and VTG > CG. The 72 h VAS score followed the order: KTG < VTG < JIG < CG. 2) The knee extension MIVC in the four groups was lowest at 24 h and then gradually increased. JIG had larger immediate MIVC than CG. KTG, VTG and JIG had larger 24 h MIVC than CG. JIG had larger 48 h MIVC than KTG and CG. Conclusion: KT and VT can reduce muscle pain and strength loss caused by DOMS to varying degrees. VT is better than KT in improving pain. The combined intervention worked better than single interventions.

Is Electrical Stimulation Effective in Preventing or Treating Delayed-onset Muscle Soreness (DOMS) in Athletes and Untrained Adults? A Systematic Review With Meta-Analysis

The effectiveness of electrical stimulation (ES) in preventing or treating delayed-onset muscle soreness (DOMS) and its effects on muscle recovery is unclear. The systematic review investigated the benefits or harms of ES on DOMS and muscle recovery. Databases (PubMed, Medline, CENTRAL, EMBASE, CINAHL, PsycINFO, PEDro, LILACS, SPORTDiscus) were searched up to March, 31st 2021 for randomized controlled trials (RCTs) of athletes or untrained adults with DOMS treated with ES and compared to placebo/sham (simulation or without ES), or control (no intervention). Data were pooled in a meta-analysis. Risk of bias (Cochrane Collaboration tool) and quality of evidence (GRADE) were analyzed. Fourteen trials (n=435) were included in this review and 12 trials (n=389) were pooled in a meta-analysis. Evidence of very low to low quality indicates that ES does not prevent or treat DOMS as well as ES does not help to promote muscle recovery immediately, 24, 48, 72, 96 hours after the intervention. Only one study monitored adverse events. There are no recommendations that support the use of ES in DOMS and muscle recovery. PERSPECTIVES: No recommendations support the use of electrical stimulation in delayed-onset muscle soreness and muscle recovery in athletes and untrained adults. This means that electrical stimulation is not fruitful for this population according those protocols used. Therefore, unlikely that further randomized controlled trials with the same approach will yield promising results.

The Effect of Pedal Pump Lymphatic Technique Versus Passive Recovery Following Maximal Exercise: A Randomized Cross-Over Trial

Context

Muscle damage and delayed onset muscle soreness (DOMS) can occur following intense exercise. Various modalities have been studied to improve blood lactate accumulation, which is a primary reason for DOMS. It has been well established that active recovery facilitates blood lactate removal more rapidly that passive recovery due to the pumping action of the muscle. The pedal pump is a manual lymphatic technique used in osteopathic manipulative medicine to increase lymphatic drainage throughout the body. Pedal pump has been shown to increase lymphatic flow and improve immunity. This may improve circulation and improve clearance of metabolites post-exercise.

Objective

This study compared the use of pedal pump lymphatic technique to passive supine recovery following maximal exercise.

Methods

17 subjects (male n = 10, age 23 ± 3.01; female n = 7, age 24 ± 1.8), performed a maximal volume O₂ test (VO₂ max) using a Bruce protocol, followed by a recovery protocol using either pedal pump technique or supine passive rest for 10 min, followed by sitting for 10 min. Outcome measures included blood lactate concentration (BL), heart rate (HR), systolic blood pressure (SBP) and VO₂. Subjects returned on another day to repeat the VO₂ max test to perform the other recovery protocol. All outcomes were measured at rest, within 1- minute post-peak exercise, and at minutes 4, 7, 10 and 20 of the recovery protocols. A 2 × 6 repeated measures ANOVA was used to compare outcome measures (p ≤ 0.05).

Results

No significant differences were found in VO₂, HR, or SBP between any of the recovery protocols. There was no significant difference in BL concentrations for recovery at minutes 4, 7, or 10 (p > 0.05). However, the pedal pump recovery displayed significantly lower BL concentrations at minute 20 of recovery (p = 0.04).

Conclusion

The pedal pump significantly decreased blood lactate concentrations following intense exercise at recovery minute 20. The use of manual lymphatic techniques in exercise recovery should be investigated further.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

REGISTRATION

number: INPLASY2021120115.

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

Background

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

Methods

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

Results

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

Conclusion

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

The effectiveness of whole-body vibration on the attenuation of delayed-onset muscle soreness in healthy untrained individuals: a randomised controlled trial

Delayed onset muscle soreness (DOMS) is a condition that happens following eccentric or intensive exercises. Whole-body vibration (WBV) is a potential treatment for DOMS; however, there is a lack of studies assessing its effectiveness in the untrained population. Our study objective was to test the efficacy of WBV compared with no treatment on pain and knee strength in healthy adults with DOMS. We randomly allocated 52 participants, 12 men and 40 women, aged 18 to 28 years, into WBV (n=26) and control (n=26) groups. The eligibility criteria included no history of injury, strengthening or aerobic exercises within the past six months. The participants walked on a treadmill to introduce DOMS. 24 h later, the WBV group received one session of WBV treatment, with their knees bent to 60° for 1 min (frequency, 30 Hz; amplitude 2-5 mm). We assessed pressure pain threshold (PPT), visual analogue scale (VAS), and knee maximum isometric force (MIF) at four time points. We did a one-way repeated measures ANOVA of each outcome measure, followed by a t-test and Bonferroni post-hoc test. The between-group differences were not significant at the baseline and 24 h post-DOMS (P>0.05). Statistical analyses revealed significant differences between the two groups for all variables at 96 h post-DOMS inducement (P<0.05), with mean differences for PPT, MIF and VAS being 1.19 kilo Pascals (95%CI = 0.78-1.32), 42.87 Newtons (95%CI = 28.53-56.98), and -2.39 (95%CI = -3.13- -1.98), respectively. Moreover, differences between the two groups were statistically significant for MIF 168 h post-DOMS (P<0.05). WBV can effectively improve pain and muscle strength; therefore, beneficial treatment for recovery of DOMS symptoms. However, determining the exact dose, frequency, and best time of application is pending future research.

Iranian Registry of Clinical Trials registration number: IRCT2016092429958N1

Local Vibration Reduces Muscle Damage after Prolonged Exercise in Men

Prolonged exercise can lead to muscle damage, with soreness, swelling, and ultimately reduced strength as a consequence. It has been shown that whole-body vibration (WBV) improves recovery by reducing the levels of stress hormones and the activities of creatine kinase (CK) and lactate dehydrogenase (LDH). The aim of the study was to demonstrate the effect of local vibration treatment applied after exercise on the level of selected markers of muscle fiber damage. The study involved 12 untrained men, aged 21.7 ± 1.05 years, with a VO₂peak of 46.12 ± 3.67 mL·kg⁻¹·min⁻¹. A maximal intensity test to volitional exhaustion was performed to determine VO₂peak and individual exercise loads for prolonged exercise. The subjects were to perform 180 min of physical effort with an intensity of 50 ± 2% VO₂peak. After exercise, they underwent a 60 min vibration treatment or placebo therapy using a mattress. Blood samples were taken before, immediately after the recovery procedure, and 24 h after the end of the exercise test. Myoglobin (Mb) levels as well as the activities of CK and LDH were recorded. Immediately after the hour-long recovery procedure (vibration or placebo), the mean concentrations of the determined indices were significantly different from baseline values. In the vibration group, significantly lower values of Mb (p = 0.005), CK (p = 0.030), and LDH (p = 0.005) were seen. Differences were also present 24 h after the end of the exercise test. The results of the vibration group compared to the control group differed in respect to Mb (p = 0.002), CK (p = 0.029), and LDH (p = 0.014). After prolonged physical effort, topical vibration improved post-workout recovery manifested by lower CK and LDH activity and lower Mb concentration compared to a control group.

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

BACKGROUND

Delayed onset muscle soreness (DOMS) is a common non-structural muscle injury which can disrupt training and impair performance in elite athletes. Vibration therapy reduces inflammation and improves neuromuscular efficiency, leading to reductions in pain and stiffness, and may be effective for the prevention or treatment of DOMS. However, the effect of whole-body vibration (WBV) used after sport in elite athletes has not been reported.

METHODS

A randomised, controlled trial was performed. Participants were elite (national or international level) hockey players and underwent an eccentric exercise protocol previously shown to produce clinical DOMS. After exercise, one group underwent static stretching with WBV therapy, and the other performed stretching only. Baseline and serial post-exercise pain scores and measurements of quadriceps tightness were obtained.

RESULTS

Eleven participants were recruited into each study arm. There were no significant differences in baseline group characteristics. Participants receiving WBV had significant reductions in both pain (p = 0.04) and quadriceps tightness (p = 0.02) compared with stretching only.

CONCLUSIONS

Post-exercise WBV is effective in elite hockey players to reduce DOMS after eccentric exercise. Elite athletes in multi-sprint sports are at risk of DOMS during training and competition, and its reduction could contribute to reduced injury risk and improved performance. This treatment modality is favourable because it can be incorporated with minimal disruption into the recovery section of existing training regimes. These findings may also be extrapolated to other multi-sprint sports.

Passive Recovery Strategies after Exercise: A Narrative Literature Review of the Current Evidence

ABSTRACT

Passive recovery techniques are popular and offer a diverse spectrum of options for athletes and the clinicians providing care for them. These techniques are intended to minimize the negative effects of training or competition, thus enabling the athlete a quicker return to peak performance. Current evidence demonstrates improved athlete recovery with compression garments, cold water immersion, partial body cryotherapy, hyperbaric oxygen, and vibratory therapies. Other popular modalities, such as compression devices, whole body cryotherapy, percussive gun-assisted therapy, neuromuscular electrical stimulation, and pulsed electromagnetic therapy lack convincing evidence concerning athlete recovery. This article seeks to review the current literature and offer the reader an updated understanding of the mechanisms for each modality and the evidence regarding each modality's potential benefit in an athlete's recovery strategy.

Comparison of Interventional Strategies to Improve Recovery after Eccentric Exercise-Induced Muscle Fatigue

The aim of this study was to compare the effects of various recovery techniques on muscle tissue after eccentric exercise-induced muscle fatigue (EIMF). Forty subjects (24.3 ± 2.6 years; 77.45 ± 8.3 kg; 177.0 ± 6.4 cm; 24.66 ± 1.6 kg∙m^-2) were randomly assigned to one of the following groups: manual therapy (n =10, MT), mechanical vibration (n = 10, MV), percussion therapy (n = 10, PT) or foam roller (n = 10, FR). The contraction time (Tc) and the radial displacement (Dm) of the gastrocnemius was evaluated through tensiomyography (TMG). The application of the different techniques had positive effects for Tc and Dm in the treated leg compared to the untreated leg (F = 50.01, p < 0.01, η²p = 0.58 and F = 27.58, p < 0.01, η²p = 0.43, respectively) and for the interaction of the factors (Time x Leg x Therapy: F = 5.76, p < 0.01, η²p = 0.32 and F = 5.93, p < 0.01, η²p = 0.33, respectively). The results of the various methods used were similar: Tc (F = 0.17, p = 0.917; η²p = 0.01) and Dm (F = 3.30, p = 0.031, η²p = 0.22). PT interventions show potential for restoring muscle compliance and reducing stiffness, similar to MT and possibly more effective (cost-time relationship) compared to MV or FR.

Immediate Effect of Local Vibration Therapy for Sport-induced Fatigue Based on Traditional Chinese Medicine's Holistic Theory

Introduction

Vibration therapy has been widely used and published in alleviating muscle fatigue. However, reports on applying vibration therapy based on the holisitic theory of traditional Chinese medicine (TCM) remains limited. This study is to evaluate the immediate effect of vibration therapy on exercise-induced muscle fatigue.

Methods

For this retrospective parallel controlled study, all data were from a previously approved and completed clinical trial. Participants (n=40) in the clinical trial included local Greco-Roman wrestling and Judo athletes in south China. The participants were equally randomly divided into the intervention group (n=20) and control group (n=20). The intervention group received a seven-week vibration intervention-based TCM holistic theory combined with conventional therapy, such as stretching, massage, and flapping, while the control group only received the conventional therapy. Surface electromyography (sEMG) of the lumbar segment of erector spinae was measured for each participant pre- and postintervention, and the two-point discrimination thresholds of the data were differentiated and compared with panel data analysis.

Results

For the control group, the pre- and postintervention sEMG measure showed no significant difference (p=0.333), whereas significant difference (p=0.004) was observed for the intervention group. Further, the pre- and postintervention two-point discrimination test also showed a significant difference (p=0.016) for the intervention group.

Discussion

The application of vibration therapy based on TCM holistic theory may have an immediate effect in reducing sport-induced muscle fatigue from intensive training. Future larger sample size and robust designed clinical trial is warranted to evaluate the long-term effect of the intervention.

Effects of Pre-exercise Acute Vibration Training on Symptoms of Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis

Tan, J, Shi, X, Witchalls, J, Waddington, G, Lun Fu, AC, Wu, S, Tirosh, O, Wu, X, and Han, J. Effects of pre-exercise acute vibration training on symptoms of exercise-induced muscle damage: a systematic review and meta-analysis. J Strength Cond Res XX(X): 000-000, 2020-Exercise-induced muscle damage (EIMD) normally occurs after unaccustomed high-intensity eccentric exercises. Symptoms of EIMD include delayed-onset muscle soreness (DOMS), tenderness, stiffness, swelling, reduced strength, and increased creatine kinase (CK) levels in the blood. Vibration training (VT) may be useful as a pre-exercise intervention in attenuating EIMD on the basis of tonic vibration reflex (TVR) through a more efficient distribution of contractile stress over muscle fibers. The objective of this meta-analysis is to examine the effects of acute VT on symptoms of EIMD when performed as the pre-exercise intervention. Randomized controlled trials (RCTs) published in the 8 databases of Cochrane Library, PubMed, Embase, Web of Science, EBSCO, China National Knowledge Infrastructure, Airiti Library and WanFang Data from 1966 (the earliest available time) to January 2019 were searched. A total of 2,324 records were identified and 448 articles were screened with the title and abstract. Two investigators identified eligible studies, extracted data, and assessed the risk of bias independently. Review Manager 5.3 designed by Cochrane was used for the current meta-analysis. Six RCTs involving 180 subjects were included in the analysis. A low-to-moderate methodological quality of the included studies was revealed using the physiotherapy evidence database scale. The results showed that acute VT was superior to the control group for the reduction of DOMS on pain visual analogue scale at 24, 48 hours and pressure pain threshold at 24 hours. In addition, superior effects of acute VT were also found on the indirect markers of muscle damage including CK at 24, 72 hours, and lactate dehydrogenase at 24 hours. The current meta-analysis has collated the evidence to demonstrate that receiving acute VT before unaccustomed high-intensity eccentric exercises may be effective in attenuating markers of muscle damage and the development of DOMS when compared with a control group. The possible mechanisms of this effect could be attributed to an improved synchronization of muscle fiber caused by TVR, which could result in even distribution of exterior loads and eventually attenuate disruptions of muscle fibers. In addition, increased blood flow may also be helpful to prevent accumulation of metabolic substances and attenuate subsequent symptoms of EIMD. Vibration training may be used as a pre-exercise intervention to alleviate symptoms of EIMD caused by unaccustomed high-intensity eccentric exercise. Because of the limited quantity and quality of included studies, more high-quality studies are required to ascertain the effect of VT on symptoms of EIMD.

The effect of vibration therapy on neck myofascial trigger points: A randomized controlled pilot study

BACKGROUND

The purpose of this study was to evaluate the effect of low-frequency self-administered vibration therapy into myofascial trigger points in the upper trapezius and levator scapulae on patients with chronic non-specific neck pain.

METHODS

Twenty-eight patients with chronic non-specific neck pain were randomly assigned into a vibration group, receiving 10 self-applied sessions of vibration therapy in the upper trapezius and levator scapulae trigger points; or a control group, receiving no intervention. Self-reported neck pain and disability (Neck Disability Index) and pressure pain threshold were assessed at baseline and after the first, fifth and 10th treatment sessions.

FINDINGS

Significant differences were found in the vibration group when compared to the control group after the treatment period: the vibration group reached lower Neck Disability Index scores (F = 4.74, P = .033, η² = 0.07) and greater pressure pain threshold values (F = 7.56, P = .01, η² = 0.10) than the control group. The vibration group reported a significant reduction in Neck Disability Index scores (χ2 = 19,35, P = .00, Kendall's W = 0.28) and an increase in pressure pain threshold (χ2 = 87,10, P = .00, Kendall's W = 0.73) between the assessment times over the course of the treatment. The mean increase in pressure pain threshold in the vibration group after the 10 sessions was 8.54 N/cm2, while the mean reduction in Neck Disability Index scores was 4.53 points.

INTERPRETATION

Vibration therapy may be an effective intervention for reducing self-reported neck pain and disability and pressure pain sensitivity in patients with chronic non-specific neck pain. This tool could be recommended for people with non-specific neck pain.