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Spormetre The Journal of Physical Education and Sport Sciences, 21(4), 2023, 21-34
21
SPORMETRE
The Journal of Physical Education and Sport Sciences
DOI: 10.33689/spormetre.1270945
29.03.2023
Kabul Tarihi (Accepted): 15.12.2023
Published): 30.12.2023
EFFECT OF ACUTE FOAM ROLLER AND PERCUSSION THERAPY ON MUSCLE
ARCHITECTURE AND MUSCLE STIFFNESS
Maryam Yektaei
1*
, Orkun Akkoç
1
,
Sergen Devran
2
,
Imren Kurtdere
1
,
Özlem Kirandi
1
,
Bulent Bayraktar
2
1Istanbul University- Cerrahpasa,
2
Abstract: The aim of the study is to investigate the effect of the acute application of foam roller and massage gun,
which are self-myofascial techniques, on muscle architecture and muscle stiffness. 27 male athletes participated in
the study. Within the scope of the study, the athletes were randomly divided into 3 groups as 1st group foam roller
(FR), 2nd group massage gun (MG), 3rd group as control group (CG) and muscle architecture and muscle stiffness
(MS) were evaluated as a result of acute exercise. Muscle stiffness (MS) muscle thickness (MT), cross-sectional
area (CSA), and pennate angles (PA) of the subjects were measured by ultrasound. The measurement results were
tested with repeated measures two-way Anova test analysis of variance in the SPSS program, and significance was
accepted as p<0.05. When the measurement results of MS, PA, and MT were examined, no significant difference
was observed in the FR, MG, and CG pre-test and post-test (p= 0.94). In the pretest and posttest results of the CSA
of the muscle, a decrease was observed in the FR group and an increase in the MG group (p=0.03). In conclusion;
shows that muscle thickness,pennation angle, and muscle stiffness do not change after acute self-myofascial
relaxations and that foam roller and massage gun do not have superiority over each other. The cross-sectional area
decreased after the foam roller application and increased after the massage gun.
Key words: Foam roller, massage gun, muscle architecture, elastography, muscle stiffness
AKUT KÖPÜK ROLLER VE VURMA TERAPİSİNİN KAS YAPISI VE KAS
SERTLİKLERİ ÜZERİNDEKİ ETKİSİ
Öz:
-test ve son
Anahtar kelimler:
*
Sorumlu Yazar: Maryam Yektaei, E-mail: m.yektaei1@outlook.com
Spormetre The Journal of Physical Education and Sport Sciences, 21(4), 2023, 21-34
22
INTRODUCTION
Skeletal muscle architecture is defined as the regulation of muscle fibers in a muscle according to
the strength generation axis (Lieber et al., 2000). Skeletal muscle architecture is one of the most
important characteristics determining the strength, power, and movement skill of a muscle. In
muscle architecture, distinguishing measurement data can be obtained in several parameters like
MS, MT, CSA, PA, and fascicule length.
Differences in a maximum inter-muscle shortening speed are closely related to the differences in
muscle fascicule length, (sarcomere number in a series) and PA (Abe et al., 2000; Frontera et al.,
2015). MT is measured from one aponeurosis to another aponeurosis. MT is related to muscle size
(Nadzalan, 2018). The increase in muscle size which is one of the indications of muscle
strengthening affects the muscle structure by increasing PA. In recent studies, MT and CSA of
muscle was reported to be a determiner in predicting isometric and isokinetic power during
contraction and relaxation (Sekir, 2022).
PA is the angle that muscle fibers build according to connective tissue and tendon. Changes in
pennation angle cause alterations in power transmission that muscle fibers transfer to the tendon
(Nadzalan, 2018; Ulubaba, 2022). How different alterations like muscle size, fascicule length, and
PA in muscle architecture affect athletic characteristics have been studied in the literature. Studies
related to PA were particularly focused. While the decrease in PA was associated with the
characteristics like power and speed, the increase in PA was associated with strength (Abe et al.,
2000; Nadzalan et al., 2018; Wakahara et al., 2012). In addition, there are studies reporting that
additional myofascial relaxing workouts decrease PA (-Sillero., 2021; Trainer et al., 2022)
The decrease in PA was associated to a decrease in the injury risk of muscle along with an increase
in muscle fascicule length. This can particularly be explained with the adaptation of muscle to
eccentric based contractions (Timmins et al., 2016).
Sports injuries, drug use, cramps, structural defects, fatigue, exercise and different type of training
methods, relaxation techniques can make alterations in MS (; Page et al., 2012).
The increase and decrease in MS may affect athletic performance negatively. For this reason, MS
trainings increase MS. In spite of that, performing stretching and other myofascial relaxation
In order not
have put the relationship between muscle stiffness and duration forward and reported that MS
decrease as relaxation exercise duration (Caliskan et al., 2019; Morales et al., 2017). MS
characteristics of lower limb has been shown to affect the performance in several athletic tasks
that are dominant in many sports like jump, running, and change of direction (Brazier et al., 2019).
However, there is a consensus about an extreme increase or decrease in this stiffness level could
affect sportive performance negatively and cause sports injuries (Koulouris et al., 2003; Kurtdere
et al., 2021).
Fascia is located in muscle groups and is the general name of a connective tissue layer surrounding
structures like blood vessels and nerves or producing muscle sheath (Lieber et al., 2000). Fascia is
Spormetre The Journal of Physical Education and Sport Sciences, 21(4), 2023, 21-34
23
placed integrally in muscular-skeletal integrally and may play a role in the transmission of power
(Benjamin et al., 2009).
Individual myofascial relaxation applications are defined as a general term used for several manual
therapy techniques performed by a pressure on muscle and fascia (McKenny et al., 2013). There
are different types of applications for relaxing fascia like massage, electric applications,
acupuncture, hot applications, stretching and exercise, FR, MG, and vibration application.
Additionally, self-myofascial relaxation is a type of a myofascial relaxation carried out by
individual by him/herself using a means not by a clinician. Most common tools used for self-
myofascial relaxation are FR and (MG) application (Beardsly et al., 2015; -Sillero., 2021;
Okamoto et al., 2014). Myofascial relaxation reduces oedema, and spasm in muscle fibers caused
muscle rigidity, stiffness, and ache. As a result of this, it causes an increase in range of motion and
flexibility after the healing of soft tissue. Individual myofascial application after massage cause
alterations in flexible structure of muscle and it enhances the genesis (biogenesis) of mitochondria,
genesis of new blood vessels (angiogenesis) or it enhances blood flow by providing blood
recirculation which is significant for muscle (Schroeder et al., 2015).
Small fluctuations stretch tissue by applying direct and wide pressure on soft tissue and produce
friction between soft tissue and FR. Friction caused by fluctuations cause facia to warm and makes
en
the layers of fascia and regains soft tissue extensibility (McDonald et al., 2013). There are studies
related to FR application enhances range of motion without negative effects on performance and
reduces delayed onset muscle pain before and after exercise (Cheatham et al., 2015). However,
there is very few knowledge related to the effect on muscle architecture in literature. Nowadays
the use of MG has become more popular. MG are usually used for alleviating muscle pain,
shortening healing period before training or competition, enhancing blood circulation, preventing
muscle spasms, and supporting muscle development (Konard et al., 2020). Despite limited
research on MG, in a study an increase was observed in range of motion following a MG
application throughout 5-min however no change was reported in power outputs. For this reason,
application was recommended to be included in warm up program (Konard et al., 2020). FR and
MG applications are intensively used in recovery, recovery of delayed onset muscle soreness,
preparation to warm up, and warm up.
The purpose of using warm up and recovery is to relax fascia, increasing blood flow and
preparation to athletic performance. FR applications performed in warm up stage enhance athletic
performance (Chen et al., 2021; Wiewelhore et al., 2019). In a study on two separate groups, while
first group conducted a warm-up combined with FR, second group conducted a general warm up.
As a result, MS was determined to be the same in both groups and there was no extra stiffness in
FR group (Morales et al., 2017). This suggests that FR applications have no negative effects on
athletic performance reducing MS On the other hand, research on the effects of alterations on
muscle architecture and structural characteristics of muscle has become more popular. Different
exercise types, exercise duration and exercise type have several effects on muscle architecture.
Acute and chronic effects of FR application from self-myofascial relaxation techniques have been
researched in literature. However, MG is a novel relaxation technique and is a matter of curiosity
whether it has strengths and weakness on other relaxation techniques. The purpose of this study
Spormetre The Journal of Physical Education and Sport Sciences, 21(4), 2023, 21-34
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was to examine FR and MG acute application from self-myofascial techniques on muscle
architecture and MS.
METHODS
Twenty- participated in this study.
Participants consisted of individuals who had no lower limb injury in the past six months. Subjects
with medical history, chronic drug use, rheumatic, systemic and/or connective tissue disorders
were not included in the study. All the participants were informed of the experimental procedure
and any potential ethical implications, and all the participants provided written informed consent.
The study was approved by the Istanbul University-Cerrahpasa Ethical Committee and was
performed in accordance with the principles of the Declaration of Helsinki seventh revision.
(Approval No: E-59491012-604. 01.02-46366).
Study Design
The study was conducted as cross over design. MG, FR and CG took place in research. Participants
were divided into three groups randomly as CG (n=9), MG (n=9), and FR (n=9). The research was
conducted as 1 day throughout 3 weeks. For example, participant X included in FR group first
week, MG second week, and CG third week. In this way each participant was included in each
separate group and by which application they had better results was determined. Participants did
not perform any physical activity in the last 48 hours before the ecercises. In order not to
experience temporal differences in the data of sessions were carried out on Saturdays
between 09:00 AM and 11:00 AM. A week before the start of the study, a familiarization study
was carried out in the application area in order to explain the study process and method to the
participants. The test began with anthropometric measurements (height, weight) then location was
marked on rectus femoris muscle of participants where ultrasound and application will be
performed. The marked location indicates the ultrasound test location. This location is the middle
point of patella superior-trochanter major. The pre-test was conducted after this application. Pre-
test and post-test application was conducted on rectus femoris dominant leg. Pre-test results were
recorded in log sheets. Ultrasound application was conducted by a practitioner who had 5 years of
experience. Right after pre-test application MG application was conducted to a group for 2-min
and other group was conducted FR for 2-min. For those who were included in CG no application
was conducted and they were asked to wait sitting for 2-min. The study was completed by
measuring the muscle CSA, MS, MT, PA with ultrasound by performing the post-test application
immediately after the myofascial release applications. The study design is shown in Figure 1.
Spormetre The Journal of Physical Education and Sport Sciences, 21(4), 2023, 21-34
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FR Group:Foam roller for two
minutes using 40 bpm tempo
with FR
One Week Break
FR Group: FR for two
minutes using 40 bpm
tempo with FR
CG: 2 minutes rest in sitting
position
MG Group:MG for 2
minutes using a 20- bpm
metronome with a
movement speed of 3200
rotations/min
CG: 2 minutes rest in sitting
position
CG:2 minutes rest in
sitting position pposition
FR Group: FR for two
minutes using 40 bpm tempo
with foam roller
MG Group: MG application
for 2 minutes using a 20-bpm
metronome with a movement
speed of 3200 rotations/min
Test 1 Test 2 Test 3
Pre-Test: Ultrasound test on the middle point of patella superior-
trochanter
Post-Test
Ultrasound test on the middle point of patella superior-
trochanter
MG Group: MG for 2
minutes using a 20-bpm
metronome with a movement
speed of 3200 rotations/min
Figure 1. The study design
Spormetre The Journal of Physical Education and Sport Sciences, 21(4), 2023, 21-34
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Demographics
kg respectively.
Devices
Myofascial Relaxation Applications
Applications were conducted on the middle point of patella superior-trochanter major. For locating
the place where ultrasound and myofascial application on rectus femoris muscle of participants up
and down sides were marked with a measuring tape and myofascial relaxations were applied in
that range.
Foam Roller
A 38 cm foam roller Nyambaplates roll was used for foam roller application. Participants proned
out for application and the foam roller was placed under the leg (right leg). Foam rollers were
applied on the rectus femoris in the leg extension and the other leg (left leg) flexion. Foam roller
application was applied to the marked area according to the midpoint of the rectus femoris for 2-
min at a tempo of 40 bpm.
Massage gun Application
For massage gun application Diesel Phoenix Massage Tool (1DIMSPHNX) was used. During the
application, the participants were held on a stretcher, knees extended, and supine position. The
massage gun was applied to the marked area according to the midpoint of the rectus femoris for 2-
min. The massage gun was used in third gear with blue lights on and the warning frequency was
as 3200 turns/min. The rate of motion was adjusted by using a 20-bpm metronome.
Ultrasound Tests
After the probe is placed longitudinally on tendon, ROI boxes in rectangular shape (with a length
of 1.5 cm and thickness of 1.0 cm) were placed from the midline (the point where the image is
more clear) of the muscle. Then measurement was performed in kPa by placing a 0.4 cm circular
ROI inside of these boxes after waiting for five seconds. A third and fourth measurements were
2017). For PA, MT, and CSA evaluations that are related to muscle architecture, measurement was
performed from the midpoint (middle of sias-patellar tendon) of rectus femoris (the point where
the image is more clear). For MT, the distance between the up and down fascia of rectus femoris
was recorded in the longitudinal section. Similarly, the angle that fascicules formed at a point
where sub-fascia of muscle for PA was, recorded. Transverse plane was used inside of the muscle
CSA, and fascia surrounding the muscle where the muscle can be seen clearly in image was tracked
for MT, the distance between up and down fascia of the rectus femoris was recorded in the
longitudinal section. Similarly, the angle that fascicules formed at a point where sub-fascia of
muscle for PA was recorded (Blazevich et al., 2005). Transverse plane was used inside of the
muscle CSA, and fascia surrounding the muscle where the muscle (Seymour et al., 2009).
ultrasound measurements were performed with the Toshiba Aplio 500 (Toshiba Medical Systems
Corporation, Otawara, Japan). A 10 MHz (5-14 MHz) lineer prob was used for these
-
Sonic 100 ultrasound gel (Parker Laboratories Inc, Fairfield, New Jersey). The rectus femoris
measurements of all individuals were performed on the ultrasound examination table, in the neutral
Spormetre The Journal of Physical Education and Sport Sciences, 21(4), 2023, 21-34
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and supine position, with the knee in full extension. Before starting the ultrasound measurements,
the athletes rested on the ultrasound examination table in a neutral position for 5-min. During the
measurement, the probe was held softly on the skin so that the pressure-related values did not
change, and a large amount of ultrasound gel was used. After all the measurements were performed
twice, next examination started. The averages of these measurements were taken during the
statistical analysis. After starting the measurements with elastography MT, MA and CSA area
were evaluated respectively. Shear wave (Toshibe Medical Systems Corporation) was used to
evaluate the mechanical properties of rectus femoris.
Statistical analysis
Statistics results were obtained using an IBM SPSS 28 package. Descriptive statistics were given
as average and standard deviation for quantitative variables, number and percent for qualitative
variables. Shapiro-Wilk test was used in the evaluation of suitability to normal distribution.
Repeated Measures two-way Anova test was used for the examination of alterations in FR, MG,
CG pre-post measurements. Anova was used for subgroups evaluation and correction of significant
results was evaluated with Bonferroni. The significance value was taken as (p<0,05).
RESULTS
Table 1. Demographic features of the participants
Demographic information
Age
Height
Weight
When the muscle stiffness measurement results were examined, foam roller pre-test was
- - -test was
- - t
difference was observed in the muscle stiffness pre-test and post-test results. When the pennation
angle measurement results were examined, foam roller pre- -test was
-post--
- No significant difference was observed in the
pennation angle pre-test and post-test results. When the cross-section area measurement results
were examined, foam roller pre---
--
post- In cross section area pre-test and post-test results, a decrease was
observed in foam roller group and an increase in massage gun group. When Muscle Thickness
measurement results were examined, foam roller pre--
massage gun pre--oup pre--
No significant difference was observed in muscle thickness pre-test and post-test
results. In addition, there was no found significant difference in all groups (p>0,05). The results
obtained, elastografi pre-test was (p=0,91), post-test was (p=0,67), PA pre-test was (p=0,12), post-
test was (p=0,7), CSA pre-test was (p=0,38), post-test was (p=0,32), MT pre-test was (p=0,99),
post-test was (p=0,34).
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Table 2.
PA: Pennation Angle, CSA: Cross Sectional Area, MT: Muscle Thickness
Tests
Test Groups
N
Mean
Std. Dev.
95% Confidence Interval
F
p
The Lowest
The Highest
Elastography
Before
Foam Roller
27
13.71
1.97
12.93
14.49
0.09
0.91
Massage Gun
27
13.96
2.94
12.8
15.12
Control
Group
27
13.97
2.6
12.95
15
Elastography After
Foam Roller
27
13.22
2.06
12.4
14.03
0.40
0.67
Massage Gun
27
13.72
2.08
12.9
14.55
Control
Group
27
13.55
2.25
12.66
14.45
PA Before
Foam Roller
27
11.02
1.69
10.35
11.69
2.14
0.12
Massage Gun
27
10.54
1.81
9.82
11.25
Control
Group
27
11.53
1.78
10.82
12.24
PA After
Foam Roller
27
11.2
2.1
10.37
12.03
0.35
0.70
Massage Gun
27
10.8
1.57
10.18
11.42
Control
Group
27
11.13
1.99
10.34
11.92
CSA Before
Foam Roller
19
11.48
1.54
10.74
12.22
0.99
0.38
Massage Gun
15
10.39
1.15
9.75
11.03
Control
Group
20
11.09
3.23
9.58
12.6
CSA After
Foam Roller
19
10.92
1.61
10.15
11.7
1.18
0.32
Massage Gun
15
10.58
1.09
9.98
11.18
Control
Group
19
11.35
1.56
10.6
12.1
MT Before
Foam Roller
27
24.18
2.98
23
25.36
0.00
0.99
Massage Gun
27
24.17
3.94
22.61
25.73
Control
Group
27
24.18
2.94
23.01
25.34
MT After
Foam Roller
27
23.48
3.09
22.26
24.7
1.09
0.34
Massage Gun
27
25.25
6.49
22.68
27.82
Control
Group
27
24.09
2.84
22.97
25.21
Spormetre The Journal of Physical Education and Sport Sciences, 21(4), 2023, 21-34
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A decrease was observed in MS values of all groups, but this was not significant (Graph1).
Graph1. Muscle stiffness (MS)
A decrease in PA in CG and an increase in FR and MG groups, however it has no statistical
significance (Graph2).
Graph 2. Pennation angle (PA)
While a decrease was observed in FR and CG in CSA, and an increase was observed in MG
group, this result was not statistically significant (Graph3).
Graph 3. Cross-sectional area (CSA)
It was observed that muscle thickness increased after massage gun and decreased after foam roller
(Graph4).
Spormetre The Journal of Physical Education and Sport Sciences, 21(4), 2023, 21-34
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Graph 4. Muscle thickness (MT)
DISCUSSION
The aim of the study is to investigate the effect of the acute application of foam roller and massage
gun, which are self-myofascial techniques, on muscle architecture and muscle stiffness. Our
measurement results of MS, PA, and MT were examined, no significant difference was observed
in the FR, MG, and CG pre-test and post-test. In the pretest and post-test results of the CSA of the
muscle, a decrease was observed in the FR group and an increase in the MG group.
A Primary School class of 30 years ve children, attended the university on 10 occasions during
the spring term for approximately 50 min (during curriculum time) to receive rugby coaching
sessions. The effects of FR and massage on the range of motion, MS, myofascial soreness and
sportive performance were examined in recent studies (-Sillero., 2021; Konard et al., 2020;
Macgregor et al., 2018). furthermore, effect of muscle architecture on acute and chronic athletic
performance were studied (Morales et al., 2017; Nadzalan et al., 2018). As new imaging techniques
such as ultrasound, magnetic resonance, shear wave elastography emerged with technological
developments; measurements of muscle architecture properties such as PA, MT, and CSA have
become easier (Lieber et al., 2000). Alterations in muscle architecture have been known to alter
athletic properties (Mangine et al., 2014; Nadzalan et al.,2018). On the other hand, it was reported
that self-myofascial applications had acute and chronic effects on athletic properties (Trainer et
al., 2022), and self-myofascial relaxation techniques were reported have effects on muscle
architecture (Torrente et al., 2022).
MT: MT is one of the most effective property from muscle architecture properties in strength and
power production. MT adjust acutely and chronically with exercise. The cause of acute thickness
enhancement is the replacement of the liquids in a cell. Also, the duration, type and velocity of
exercise can be effective in the alteration of MT. It was determined that there was an increase in
MT following acute strength and power workouts (Gaspari et al., 2021), Contrary to this, MT is
expected to increase after relaxations such as FR and self-myofascial application (Freiwald et al.,
2016). A FR study on nine trained men who did resistance exercises and compared 3-min FR
application to 1-min FR application. As a result of 3-min FR application an increase observed in
vastus lateralis MT, and they recommended 3-min and longer FR applications for an increase in
MT (Brigatto et al., 2021).
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CSA: An increase in the CSA of skeletal muscle fibers is termed fiber hypertrophy and is generally
regarded as the primary adaptation in long-term strength training (Jones et al., 1989). Muscle
strength is proportional to muscle CSA (McDonagh et al., 1984). When discussing the CSA of a
muscle, it should also be noted that the CSA consists of several parts that make up the total muscle
CSA, including non-contractile tissue such as blood vessels. The volume of sarcomeres (i.e
contractile proteins) is often associated with CSA. Common adaptations based on activity levels
such as changes in intravascular and interstitial volume, changes in mitochondrial density and
muscle glycogen density also contribute to muscle CSA (Jones et al., 2008). When myofascial
release studies using FR and MG are examined in the literature, these studies are mostly related to
joint range of motion (McDonald et al., 2013; Trainer et al., 2022). delayed onset muscle soreness
(DOMS) (-Sillero et al., 2021), and MS (Morales et al., 2017), and there is little data on the
CSA of the muscle. In the current study, it was seen that FR application decreased CSA and MG
increased CSA. The fact that FR application reduced CSA is compatible with the literature, and
the increase in the MG is thought provoking. The increase in CSA of the MG suggests a possible
muscular activity. More studies are needed to understand the effect of the MG on CSA. Exercise,
various training, and relaxation methods alter MS (; Page et al., 2012).
MS: The volume and severity of the method are as important as the method applied in alterations
in muscle MS (Kurtdere et al., 2021). They emphasized that MS was affected by the duration of
the application from this result. -Sillero et al. (2021), in their acute studies in which they
compared the effects of foam roller (FR), manual therapy (massage), MG application and
mechanical vibration recovery techniques on muscle tissue through the tensiomyography method,
percussion intervention was similar to manual therapy and probably more effective than
mechanical vibration or FR application ( cost-time relationship) and it showed the potential to
restore muscle compliance and reduce stiffness(-Sillero et al., 2021). In the current study,
MS did not alter in both groups. The reason why it did not change may depend on the duration of
therapy applied.
PA: alterations in PA as a result of myofascial studies are still being investigated. In a study of
Torrente et al. with a total of twenty-five young, athletic male volunteers, they performed a one
minute foam roller application for each leg along the full length of both thighs, three times a week,
on three separate days for seven weeks and they used ultrasound to determine first and last vastus
medialis oblic and vastus lateralis PA. It was reported that a significant decrease in PA was
observed in vastus medialis and vastus lateralis muscles after seven weeks of foam roller
application. It was reported that balance should be maintained in the PA of the vastus medialis
oblique and vastus lateralis muscles in order to maintain the normal movement pattern of the knee.
They reported that in case of a loss of PA balance between these two muscles, patellofemoral pain
emerges, and an alteration between two muscles could be possible with either increasing muscle
fiber angle through targeted exercises or decreasing the angle through stretching exercises
(Torrente et al., 2022). Several of these variables were not fully exploredin the included studies or
There is a lack of information in the literature on this subject and it has not been researched. To
obtain better quality research, in future studies, we endorse applying these applications on different
muscle groups, using different type of massage gun and foam roller, or performing the application
for different periods of time.
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CONCLUSION
This study found that self-myofascial relaxations do not change MS, MT and PA. FR and MG
applications were not superior to each other in PA, MT and MS. In addition, FR application
decreased CSA and MG increased CSA. The decrease in CSA with FR application is compatible
with the literature, and it is surprising that the MG increases CSA. Future studies may examine
how MG can increase MT and CSA through which physiological and cellular alterations. In this
study, we investigated the acute effects of MG and FR on rectus femoris muscle architecture and
MS for 2-min, but no significant differences were found. However, it is still unclear that using of
a MG device can effect on muscle architecture in a longer period of time. Subsequently, future
research should investigate how long the acute changes in muscle architecture and MS last for
after a single application of a MG device. Future research should also focus on the long-term
effects of repeated MG use over a period of consecutive days.
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