Continuous Low-Level Heat Wrap Therapy for the Prevention and Early Phase Treatment of Delayed-Onset Muscle Soreness of the Low Back: A Randomized Controlled Trial

Procter & Gamble, Cincinnati, Ohio, United States
Archives of Physical Medicine and Rehabilitation (Impact Factor: 2.57). 10/2006; 87(10):1310-7. DOI: 10.1016/j.apmr.2006.07.259
Source: PubMed


To evaluate the effects of continuous low-level heat wrap therapy for the prevention and early phase treatment (ie, 0-48 h postexercise) of delayed-onset muscle soreness (DOMS) of the low back.
Two prospective randomized controlled trials.
Outpatient medical facility.
Sixty-seven subjects asymptomatic of back pain and in good general health (mean age, 23.5+/-6.6 y).
Participants performed vigorous eccentric exercise to experimentally induce low back DOMS. Participants were assigned to 1 of 2 substudies (prevention and treatment) and randomized to 1 of 2 treatment groups within each substudy: prevention study (heat wrap, n=17; control [nontarget muscle stretch], n=18) and treatment study (heat wrap, n=16; cold pack, n=16). Interventions were administered 4 hours before and 4 hours after exercise in the prevention study and between hours 18 to 42 postexercise in the treatment study.
To coincide with the expected occurrence of peak symptoms related to exercise-induced low back DOMS, hour 24 postexercise was considered primary. Pain intensity (prevention) and pain relief (treatment) were primary measures, and self-reported physical function and disability were secondary measures.
In the prevention study, at hour 24 postexercise, pain intensity, disability, and deficits in self-reported physical function in subjects with the heat wrap were reduced by 47% (P<.001), 52.3% (P=.029), and 45% (P=.013), respectively, compared with the control group. At hour 24 in the treatment study, postexercise, pain relief with the heat wrap was 138% greater (P=.026) than with the cold pack; there were no differences between the groups in changes in self-reported physical function and disability.
In this small study, continuous low-level heat wrap therapy was of significant benefit in the prevention and early phase treatment of low back DOMS.

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Available from: Leonard Neil Matheson, Oct 05, 2015
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    • "The biochemistry for DOMS involves multiple biological markers for tissue damage. Blood tests have shown elevation in muscle myoglobin, heat shock proteins 27 and 40, and interleukin-6 and interleukin-10 in subjects suffering from DOMS [8] [9] [10] [11]. Pain generally begins three hours after exercise, peaks from 24 to 72 h post-exercise, and fades over 5 to 7 d [13] [14]. "
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    ABSTRACT: Assessment of muscle damage relies commonly on subjective sensation of pain. The purpose of this research was to test the validity of microcurrent conductance on skin over injured tissue to quantify soft tissue injury and recovery following heavy exercise compared to other indexes of muscle soreness. A randomized, controlled, single-blinded, 1-week trial on 60 subjects. Setting-University Interventions: Subjects did 3 sets of squats for 5 min each. There were 3 groups of 20 subjects. One did nothing and one had heat applied for 8 h post exercise. The final group had heat 24 h after exercise. Tissue resistance and muscle strength force to move the knee, analog visual pain scale. In the control group, microcurrent continually decreased, eventually decreasing 32% by the third day post exercise. When heat was given immediately following exercise, microcurrent was 26% greater (P < 0.001). The pain scale rose to 3.1/10 as opposed to 5.4/10 for controls. Strength and muscle elasticity stayed mostly constant after heat as opposed to a 28% decrease in strength and increase in stiffness in the control subjects. For 24 h delayed heat, microcurrent was 14% greater (P < 0.02), and was unchanged for the first 24 h when no therapy was given. Pain scale rose to 4.8/10. Stiffness was unchanged while muscle strength decreased the same as controls. Microcurrent shows agreement with loss of strength, and stiffness from DOMS but not the subjective pain measure. It appears that microcurrent is a good measure of muscle damage.
    Journal of health science 08/2014; 2(11):353-362. · 0.80 Impact Factor
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    • "For example, the response to occlusion is blunted in people from Thailand compared to Caucasians [2]. While occlusion is a useful clinical test, it is more practical to examine the response to other stressors such as to heat since heat is used as a therapeutic modality [23–25]. Many of the same genes as seen in people from Thailand are found in Southeast Asian Indians. "
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    ABSTRACT: The reaction of vascular endothelial cells to occlusion and heat in Southeast Asian Indians (SAI) compared to Caucasians (C) has not been studied, although genetic differences are found in endothelial cells between the races. Ten C and Ten SAI (<35 years old) male and female subjects participated. There was no difference in the demographics of the subjects except that the SAI group had been in the United States for 6 months; C was natives to the US. Endothelial function was assessed by the response of the circulation (BF) to local heating and the response to vascular occlusion. The effects of local heat on circulation in the skin on the forearm was assessed by applying heat for 6 minutes at temperatures, 38, 40 and 42°C on 3 separate days. On different days, vascular occlusion was applied for 4 minutes to the same arm and skin blood flow was measured for 2 minutes after occlusion; skin temperature was either 31°C or 42°C. When occlusion was applied at a skin temperature of 31°C, the BF response to occlusion was significantly lower in the SAI cohort compared to C (peak BF C = 617 ± 88.2 flux, SAE = 284 ± 73 flux). The same effect was seen at skin temperatures of 42°C. The circulatory response to heat was also significantly less in SAI compared to C at each temperature examined (p<0.05)(for temperatures of 38, 40 and 42°C, peak blood flow for C was 374.7 ± 81.2, 551.9 ± 91.3 and 725.9 ± 107 flux respectively and 248.5 ± 86.2, 361.4 ± 104.3 and 455.3 ± 109.7 flux respectively for SAI. (p<0.05). Thus there seems to be big differences in these 2 populations in endothelial response to these stressors. The difference may be due to genetic variations between the 2 groups of subjects.
    Medical science monitor: international medical journal of experimental and clinical research 12/2011; 18(1):CR1-8. DOI:10.12659/MSM.882185 · 1.43 Impact Factor
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    • "In DOMS models that involve peripheral (non-axial) muscles common protocols target a primary muscle or muscle group in which the DOMS is to be induced. Active trunk exercises have been used to generate DOMS in the trunk [19,20]. Therefore we had two general goals to extend previous work in this area. "
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    ABSTRACT: Our purpose was to develop an induced musculoskeletal pain model of acute low back pain and examine the relationship among pain, disability and fear in this model. Delayed onset muscle soreness was induced in 52 healthy volunteers (23 women, 17 men; average age 22.4 years; average BMI 24.3) using fatiguing trunk extension exercise. Measures of pain intensity, unpleasantness, and location, and disability, were tracked for one week after exercise. Pain intensity ranged from 0 to 68 with 57.5% of participants reporting peak pain at 24 hours and 32.5% reporting this at 48 hours. The majority of participants reported pain in the low back with 33% also reporting pain in the legs. The ratio of unpleasantness to intensity indicated that the sensation was considered more unpleasant than intense. Statistical differences were noted in levels of reported disability between participants with and without leg pain. Pain intensity at 24 hours was correlated with pain unpleasantness, pain area and disability. Also, fear of pain was associated with pain intensity and unpleasantness. Disability was predicted by sex, presence of leg pain, and pain intensity; however, the largest amount of variance was explained by pain intensity (27% of a total 40%). The second model, predicting pain intensity only included fear of pain and explained less than 10% of the variance in pain intensity. Our results demonstrate a significant association between pain and disability in this model in young adults. However, the model is most applicable to patients with lower levels of pain and disability. Future work should include older adults to improve the external validity of this model.
    BMC Musculoskeletal Disorders 02/2011; 12(1):35. DOI:10.1186/1471-2474-12-35 · 1.72 Impact Factor
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