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The efficacy of frequency specific microcurrent therapy on delayed onset muscle soreness
Abstract and Figures
This study compared the effects of frequency specific microcurrent (FSM) therapy versus sham therapy in delayed onset muscle soreness (DOMS) in order to determine whether specific frequencies on two channels would produce better results than single channel single frequency microcurrent therapy which has been shown to be ineffective as compared to sham treatment in DOMS. 18 male and 17 female healthy participants (mean age 32+/-4.2 years) were recruited. Following a 15-min treadmill warm-up and 5 sub-maximal eccentric muscle contractions, participants performed 5 sets of 15 maximal voluntary eccentric muscle contractions, with a 1-min rest between sets, on a seated leg curl machine. Post-exercise, participants had one of their legs assigned to a treatment (T) regime (20 min of frequency specific microcurrent stimulation), while the participant's other leg acted as control (NT). Soreness was rated for each leg at baseline and at 24, 48 and 72 h post-exercise on a visual analogue scale (VAS), which ranged from 0 (no pain) to 10 (worst pain ever). No significant difference was noted at baseline p=1.00. Post-exercise there was a significant difference at 24h (T=1.3+/-1.0, NT=5.2+/-1.3, p=0.0005), at 48 h (T=1.2+/-1.1, NT=7.0+/-1.1, p=0.0005) and at 72 h (T=0.7+/-0.6, NT=4.0+/-1.6, p=0.0005). FSM therapy provided significant protection from DOMS at all time points tested.
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... The ability of MTC to increase ATP within the stimulated tissue in healthy physically active individuals has been shown to increase the energy available to the cells, which may facilitate muscle mass gain and maintenance throughout the lifespan and improve performance by enhancing recovery after exercise sessions in athletes. Compared to sham treatment, researchers documented that MCT applied in acute trials attenuates markers of muscle damage (Curtis et al. 2010;Kwon et al. 2017;Lambert et al. 2002), and reduces perceived exercise-induced exhaustion (Stosslein and Kuypers 2022). Indeed, two randomised controlled trial interventions confirmed the positive effect of MCT to attenuate the perception of delayed-onset muscle soreness (DOMS, a marker of muscle damage) in both resistance-trained (Naclerio et al. 2019) and endurance athletes (Naclerio et al. 2021). ...
... For instance, electro-membrane microcurrent therapy applied for a period for 96 h reduced the severity of DOMS symptoms in healthy men in a double-blind, placebo-controlled trial after performing eccentric contractions of the nondominant elbow flexor muscles (Lambert et al. 2002). Similarly, the application of MCT using a specific frequency (a modality of MCT including a particular list of frequencies designated to target specific tissues or health-related conditions) for 20 min attenuated the perception of DOMS in the MCT (Curtis et al. 2010). In addition, a similar specific MCT applied for 30 min post-exercise in healthy resistance-trained young men (18-40 years old) reduced exercise-induced exhaustion based on self-reported questionnaires (Stosslein and Kuypers 2022). ...
... MCT has the potential to reduce the severity of post-exercise DOMS (Curtis et al. 2010), as well as to improve exerciseinduced adaptations in humans, e.g. enhance muscle function, preserve or increase lean mass, etc. (Kwon et al. 2017), reducing fat (Noites et al. 2015) or enhance recovery from exercise (Piras et al. 2021). ...
Microcurrent is a non-invasive and safe electrotherapy applied through a series of sub-sensory electrical currents (less than 1 mA), which are of a similar magnitude to the currents generated endogenously by the human body. This review focuses on examining the physiological mechanisms mediating the effects of microcurrent when combined with different exercise modalities (e.g. endurance and strength) in healthy physically active individuals. The reviewed literature suggests the following candidate mechanisms could be involved in enhancing the effects of exercise when combined with microcurrent: (i) increased adenosine triphosphate resynthesis, (ii) maintenance of intercellular calcium homeostasis that in turn optimises exercise-induced structural and morphological adaptations, (iii) eliciting a hormone-like effect, which increases catecholamine secretion that in turn enhances exercise-induced lipolysis and (iv) enhanced muscle protein synthesis. In healthy individuals, despite a lack of standardisation on how microcurrent is combined with exercise (e.g. whether the microcurrent is pulsed or continuous), there is evidence concerning its effects in promoting body fat reduction, skeletal muscle remodelling and growth as well as attenuating delayed-onset muscle soreness. The greatest hindrance to understanding the combined effects of microcurrent and exercise is the variability of the implemented protocols, which adds further challenges to identifying the mechanisms, optimal patterns of current(s) and methodology of application. Future studies should standardise microcurrent protocols by accurately describing the used current [e.g. intensity (μA), frequency (Hz), application time (minutes) and treatment duration (e.g. weeks)] for specific exercise outcomes, e.g. strength and power, endurance, and gaining muscle mass or reducing body fat.
... Additionally, the longer-lasting duration of positive effects of MS has also been demonstrated previously; A 20 min MS of healthy volunteers' hamstring protected from pronounced self-rated delayed onset muscle soreness (DOMS) 24 h after exercises (sets of seated leg curls). This effect extended to 72 h after the exercises and the MS, compared to the sham-stimulation after exercises (Curtis et al., 2010). Of note, DOMS increased independently of treatment, i.e., with or without MS; however, it was lower in the MS condition than in the sham condition. ...
... Of note, DOMS increased independently of treatment, i.e., with or without MS; however, it was lower in the MS condition than in the sham condition. The DOMS ratings returned to baseline 72 h post-exercise and MS, while still elevated in the sham condition (Curtis et al., 2010). When applied daily after upper and lower body exercises and at non-training days, 3 h of MS led to a greater pennation angle than sham-stimulation, reducing DOMS 12, 24, and 48 post-exercise (Naclerio et al., 2019). ...
Background
Resistance training (RT) can offer beneficial physiological and psychological effects. The regular continuation of this exercise can be accomplished by improving the recovery and mood after a workout. Frequency-specific microcurrent (microstimulation) might offer a solution here as it has been shown to improve physical injuries, mood state, and sleep. However, knowledge is lacking about the impact of microstimulation after RT on said parameters. The present study aimed to test the effects of RT and muscle-microstimulation on mood and physical recovery in healthy men after performing conventional deadlifts, which is a type of RT.
Methods
The study was conducted according to a single-blind, randomized, placebo-controlled, and two-way crossover study. Twenty participants naïve to microstimulation (MS) engaged in RT twice on separate days. They were randomized to receive MS on 1 day and no microstimulation (Sham-MS) on another day. Before and after the workout and after their treatment (MS or Sham-MS), participants self-rated their mood state and mental and physical exhaustion levels.
Results
Findings showed that MS increased the self-ratings of well-rested and sociable and, most importantly, reduced the feeling of exercise-induced exhaustion. There were no MS effects on ratings of feeling sad, happy, or exhausted, although the workout, independent of MS, negatively influenced the level of exhaustion.
Conclusion
The combination of enhanced sociableness, reduced fatigue, and exercise-induced exhaustion after a workout, followed by microstimulation, has important implications for professional sporters and nonprofessionals who try to get the best result after a workout. Future studies using a double-blind approach including different types of exercises, different durations of programs, and both sexes can shed more light on the full potential of microstimulation after a workout on mood state and exercise-induced exhaustion.
... For electrotherapy, the protocols used varied between TENS, micro-currents and interferential current, so that seven studies (Curtis et al., 2010;Denegar & Perrin, 1992 Craig et al., 1996a;Jajtner et al., 2015;Lambert et al., 2002;Malmir et al., 2017;Minder et al., 2002;Tourville, Connolly, & Reed, 2006;Vanderthommen et al., 2007;Weber et al., 1994) found no effects. On ultrasound, two studies (Aaron et al., 2017;Hasson et al., 1990) showed significant effects, while five studies (Aytar et al., 2008;Craig et al., 1999a;Parker & Madden, 2014;Plaskett et al., 1999;Shankar et al., 2006) did not observe effects. ...
... The methodological evaluation of the quality of the studies has yielded an average of 4.7 points on the PEDro scale. Sixteen studies were considered "high quality" (Aaron et al., 2017;Aytar et al., 2008;Chang et al., 2019;Craig et al., 1999b;de Paiva et al., 2016;Ferreira-Junior et al., 2015;Fleckenstein et al., 2016Fleckenstein et al., , 2017 R.L. Nahon, J.S. Silva A. Monteiro de Magalhães Neto Physical Therapy in Sport 52 (2021) 1e12 et al., 2002;Mikesky & Hayden, 2005;Selkow et al., 2015;Sellwood et al., 2007;Vinck et al., 2006); 42 studies were considered "moderate quality" (Adamczyk et al., 2016;Andersen et al., 2013;Butterfield et al., 1997;Changa et al., 2020;Craig et al., 1996b;Curtis et al., 2010;Doungkulsa et al., 2018;Elias et al., 2012;Glasgow et al., 2014;Guilhem et al., 2013;Hart et al., 2005;Hasson et al., 1990;Hazar Kanik et al., 2019;Hoffman et al., 2016;Howatson et al., 2008;Jayaraman et al., 2004;Jeon et al., 2015;Johar et al., 2012;Kirmizigil et al., 2019;Kong et al., 2018;Law & Herbert, 2007;Leeder et al., 2015;Macdonald et al., 2014;Machado et al., 2017;Malmir et al., 2017;McLoughlin et al., 2004;Micheletti et al., 2019;Naderi et al., 2020;Paddon-Jones & Quigley, 1997;Rey et al., 2012;Rocha et al., 2012;Romero-Moraleda et al., 2019;Siqueira et al., 2018;Smith et al., 1994;Tourville et al., 2006;Wang et al., 2006;Weber et al., 1994;Wiewelhove et al., 2018;Xie et al., 2018;Zebrowska et al., 2019;Zhang et al., 2000) and 63 studies were considered "low quality" (Akinci et al., 2020;Behringer et al., 2018;Boobphachart et al., 2017;Carling et al., 1995;Ferguson et al., 2014;Haksever et al., 2016;Hill et al., 2017;Imtiyaz et al., 2014;Jakeman et al., 2010aJakeman et al., , 2010bKraemer et al., 2001;Lau & Nosaka, 2011;Northey et al., 2016;Ozmen et al., 2017;Pearcey et al., 2015;Prill et al., 2019;Rhea et al., 2009;Timon et al., 2016;Vaile et al., 2007Vaile et al., , 2008Visconti et al., 2020;Wheeler & Jacobson, 2013) , (Ascensão et al., 2011;Hassan, 2011;Hilbert et al., 2003;Howatson & Van Someren, 2003;Jajtner et al., 2015;Kargarfard et al., 2016;Lightfoot et al., 1997;Marquet et al., 2015;Micklewright, 2009;Tiidus & Shoemaker, 1995;Torres et al., 2013;Weber et al., 1994;Wessel & Wan, 1994;Xiong et al., 2009;Zainuddin et al., 2005) , (Abaïdia et al., 2017;Barlas et al., 2000;Cardoso et al., 2020;Craig et al., 1996aCraig et al., , 1999aHowatson et al., 2005;Itoh et al., 2008;Mankovsky-Arnold et al., 2013;Minder et al., 2002;Parker & Madden, 2014;Petrofsky et al., 2012;Plaskett et al., 1999;Shankar et al., 2006;Taylor et al., 2015;Tseng et al., 2013;Tufano et al., 2012;Vanderthommen et al., 2007;Zainuddin et al., 2006) (See details in Appendix 3). The overall analysis results showed that there was "low quality evidence" (according to GRADE classification). ...
Objective
To evaluate the impact of interventions on pain associated with DOMS.
Data sources
PubMed, EMBASE, PEDro, Cochrane, and Scielo databases were searched, from the oldest records until May/2020. Search terms used included combinations of keywords related to “DOMS” and “intervention therapy”.
Eligibility criteria
Healthy participants (no restrictions were applied, e.g., age, sex, and exercise level). To be included, studies should be: 1) Randomized clinical trial; 2) Having induced muscle damage and subsequently measuring the level of pain; 3) To have applied therapeutic interventions (nonpharmacological or nutritional) and compare with a control group that received no intervention; and 4) The first application of the intervention had to occur immediately after muscle damage had been induced.
Results
One hundred and twenty-one studies were included. The results revealed that the contrast techniques (p = 0,002 I² = 60 %), cryotherapy (p = 0,002 I² = 100 %), phototherapy (p = 0,0001 I² = 95 %), vibration (p = 0,004 I² = 96 %), ultrasound (p = 0,02 I² = 97 %), massage (p < 0,00001 I² = 94 %), active exercise (p = 0,0004 I² = 93 %) and compression (p = 0,002 I² = 93 %) have a better positive effect than the control in the management of DOMS.
Conclusion
Low quality evidence suggests that contrast, cryotherapy, phototherapy, vibration, ultrasound, massage, and active exercise have beneficial effects in the management of DOMS-related pain.
... Previous studies reported the effectiveness of microcurrent to increase myogenesis differentiation in animals (Ohno et al., 2019), activating intracellular signalling pathways for triggering the mechanistic target of rapamycin complex 1 (mTORC1) favouring a more efficient muscle protein synthesis response (Moon, Kwon, & Lee, 2018;Ohno et al., 2019). Furthermore, compared to sham treatment, acute microcurrent therapy attenuates markers of muscle damage in humans after applications lasting 20 minutes (Curtis, Fallows, Morris, & McMakin, 2010), 40 minutes (Kwon et al., 2017) and 96 hours (Lambert, Marcus, Burgess, & Noakes, 2002) in humans. ...
... On the other hand, similarly with previous studies (Curtis et al., 2010;Lambert et al., 2002;Naclerio et al., 2019), the application of the microcurrent reduced the perception of DOMS after performing a severe exercise bout (Figure 3). In our study, the regular post-exercise application of microcurrent could have optimised the capacity of the muscles to attenuate the induced muscular disruption by the maintenance of a more favourable intracellular Ca2 + homeostasis, after the completion of the EIMS protocol (Naclerio et al., 2019). ...
Post-exercise microcurrent based treatments have shown to optimise exercise-induced adaptations in athletes. We compared the effects of endurance training in combination with either, a microcurrent or a sham treatment, on endurance performance. Additionally, changes in body composition, post-exercise lactate kinetics and perceived delayed onset of muscle soreness (DOMS) were determined. Eighteen males (32.8±6.3 years) completed an 8-week endurance training programme involving 5 to 6 workouts per week wearing a microcurrent (MIC, n=9) or a sham (SH, n=9) device for 3-h post-workout or in the morning during non-training days. Measurements were conducted at pre- and post-intervention. Compared to baseline, both groups increased (P<0.01) maximal aerobic speed (MIC, pre =17.6±1.3 to post=18.3±1.0; SH, pre=17.8±1.5 to post =18.3±1.3 km.h⁻¹) with no changes in O2peak. No interaction effect per group and time was observed (P=0.193). Although both groups increased (P<0.05) trunk lean mass (MIC, pre=23.2±2.7 to post=24.2±2.0; SH, pre=23.4±1.7 to post=24.3±1.6 kg) only MIC decreased (pre=4.8±1.5 to post=4.5±1.5, p=0.029) lower body fat. At post-intervention, no main differences between groups were observed for lactate kinetics over the 5 min recovery period. Only MIC decreased (P<0.05) DOMS at 24-h and 48-h, showing a significant average lower DOMS score over 72-h after the completion of the exercise-induced muscle soreness protocol. In conclusion, a 3-h daily application of microcurrent over an 8-week endurance training programme produced no further benefits on performance in endurance-trained males. Nonetheless, the post-workout microcurrent application promoted more desirable changes in body composition and attenuated the perception of DOMS over 72-h post-exercise.
Trial registration: ClinicalTrials.gov identifier: NCT03477747..
... In a similar study on muscle injury, healing mechanisms, such as amino acid transport, triphosphate production, and protein synthesis, were boosted by 30-40% above the control level of an intensity of 100-500 μA; however, these biostimulatory effects were ineffective when the intensity went over 1,000 μA [42]. In fact, treating muscle-related disorders with an intensity of 10-50 μA amplitude has been advised [48]; a low amperage electric current of <500 μA is useful in reducing the severity of muscle symptoms in muscle damage [49][50][51]; and these are also optimal for ATP generation [42]. These findings support the findings of this study, which show that low-amperage electric currents increase skeletal muscle regeneration more than high-amperage electric currents. ...
Background:
The aim of this study was to evaluate how polydeoxyribonucleotide (PDRN) and microcurrent therapy (MT) functioned synergistically in a cast-immobilized rabbit model with an atrophied calf muscle.
Methods:
At the age of 12 weeks, 32 male New Zealand rabbits were enrolled in four groups. After 2 weeks of cast-immobilization, 4 procedures were performed on atrophied calf muscle [weekly two injections normal saline 0.2 ml injection group 1 (G1-NS), weekly two injections 0.2 ml PDRN injection group 2 (G2-PDRN), MT group 3 (G3-MT), and 0.2 ml PDRN injection with MT group 4 (G4-PDRN+MT)]. For 2 weeks, MT was used for 60 minutes each day. The calf circumference (CC), the thickness of gastrocnemius muscle (TGCM), and the tibial nerve compound muscle action potential (CMAP) were evaluated using ultrasound before and after 2 weeks of treatment. Proliferating cell nuclear antigen (PCNA), vascular endothelial growth factor, and platelet endothelial cell adhesion molecule-1 (PECAM-1) of GCM fibers (type I, type II, and total) were measured. Statistical analyses were performed using ANOVA.
Results:
The mean atrophic alterations of right CC, CMAP, and TGCM (medial/lateral) were substantially lower in G4-PDRN+MT than in the G1-NS, G2-PDRN, and G3-MT, respectively (p < 0.05). Furthermore, mean CSAs (type I, type II, and total) of medial and lateral GCM muscle fibers in G4-PDRN+MT were significantly higher when compared to other three groups (p < 0.05). In terms of the PCNA-, VEGF-, and PECAM-1-positive cell ratio of medial and lateral GCM muscle fibers, G4-PDRN+MT was considerably higher than G1-NS, G2-PDRN, and G3-MT (p < 0.05).
Conclusions:
On the atrophied calf muscle of the rabbit model, PDRN injection combined with MT was more effective than PDRN injection alone, MT alone, and normal saline injection separately.
... Some interventions like cryotherapy [7] had some positive effects on muscle soreness or other DOMS symptoms while some other methods like stretching [8,9] , demonstrated no effect on the alleviation of DOMS. Massage [10] , vibration [11] ultrasound and electrical current modalities [4,12] have shown controversial effects. In addition, exercises are among the most effective means to alleviate pain in DOMS; however, the analgesic effect is temporary [13] . ...
... Applying electrical stimulation produces current flow in the tissues that mimics the natural skin battery, and thereby, promotes tissue healing. MENS has been shown to have beneficial effects in terms of wound healing 40,41 ) , pressure ulcer healing 42 ) , tendon or ligament repair 43,44) , the alleviation of muscle soreness 45,46 ) , and muscle regrowth 47) . The therapeutic effects of MENS on muscle injury have been evaluated in regard to muscle weight, muscle protein content, mean muscle fiber cross-sectional area, and number of muscle satellite cells 48) (Table 4). ...
Skeletal muscle injury is caused by a variety of events, such as muscle laceration, contusions, or strain. Muscle fibers respond to minor damage with immediate repair mechanisms that reseal the cell membrane. On the other hand, repair of irreversibly damaged fibers is achieved by activation of muscle precursor cells. Muscle repair is not always perfect, especially after severe damage, and can lead to excessive fibroblast proliferation that results in the formation of scar tissue within muscle fibers. Remaining scar tissue can impair joint movement, reduce muscular strength, and inhibit exercise ability; therefore, to restore muscle function, minimizing the extent of injury and promoting muscle regeneration are necessary. Various physical agents, such as cold, thermal, electrical stimulation, and low-intensity pulsed ultrasound therapy, have been reported as treatments for muscle healing. Although approaches based on the muscle regeneration process have been under development, the most efficacious physiological treatment for muscle injury remains unclear. In this review, the influence of these physical agents on muscle injury is described with a focus on research using animal models.
... Previous studies including cryotherapy [5], electrotherapy [6], stretching [7], antiinflammatory drugs [8], ultrasound [5], hyperbaric oxygen therapy [9], acupuncture [10], taping [7] and massage [11] to alleviate DOMS and to restore muscle function have reported conflicting results. Massage has been widely used in recovery of athletes from exercise and rehabilitation of patients for years. ...
The aim of this study was to investigate effects of classic massage with peppermint oil or vaseline on muscle pain and muscle strength during recovery from exercise. Twenty-two healthy males between the ages of 18 to 22 years participated in this study. All participants carried out 10 set of 10 repetitions eccentric exercises of wrist flexors with elastic bands. The participants were randomly divided into two intervention groups as the peppermint oil and the vaseline massage. Ten minutes of classic massage was performed to one arm of participants after exercise and no massage was performed to contralateral arm. Muscle soreness was evaluated using pressure algometry. Grip strength was measured with JAMAR dynamometer. No significant differences were found for muscle soreness in both peppermint oil and vaseline massage arm from baseline to 24 h and 48 h (p>.05). There were significant differences from baseline to 24 h (p=0.031) and 48 h (p=0.023) post-exercise in peppermint oil control arm for muscle soreness. Also, there was a significant difference from baseline to 24 h (p=0.016) in the vaseline control arm. No significant differences were found for grip strength after exercise in all conditions (p>.05). There were no significant differences between peppermint oil and vaseline massage arm for both muscle soreness and grip strength (p>.05). The classic massages with peppermint oil and vaseline alleviated muscle soreness during recovery after exercise. But, both massage interventions did not contribute to recovery of grip strength after exercise. Bu çalışmanın amacı, egzersizden toparlanma sırasında nane yağı veya vazelin ile klasik masajın etkisini araştırmaktı. Bu çalışmaya 18-22 yaşları arasında 22 sağlıklı erkek katıldı. Tüm katılımcılar elastik bantlar ile 10 set 10 tekrar el bileği fleksiyon egzersizleri yaptılar. Katılımcılar rastgele nane yağı ve vazelin masajı olarak iki müdahale grubuna ayrıldı. Katılımcıların bir koluna egzersiz sonrası 10 dakika klasik masaj yapıldı ve diğer kola masaj yapılmadı. Kas ağrısı basınç algometresi kullanılarak değerlendirildi. Kavrama kuvveti JAMAR dinamometresi ile ölçüldü. Hem nane yağı hem de vazelin masaj kolunda egzersiz öncesi 24 saat ve 48 saate kadar kas ağrısı açısından anlamlı fark bulunmadı (p> .05). Kas ağrısı için nane yağı masajı kontrol kolunda egzersiz öncesinden egzersiz sonrası 24 saat (p = 0.031) ve 48 saate (p = 0.023) anlamlı farklılıklar vardı. Ayrıca, vazelin kontrol kolunda, egzersiz öncesinden egzersiz sonrası 24 saate (p = 0.016) anlamlı bir fark vardı. Her koşulda egzersiz sonrası 24 saatte ve 48 saatte kavrama gücü için anlamlı fark bulunmadı (p> 0.05). Hem kas ağrısı hem de kavrama kuvveti için nane yağı masaj ve vazelin masaj kolu arasında anlamlı fark yoktu (p> 0.05). Nane yağı ve vazelin ile klasik masaj, egzersiz sonrası toparlanma sırasında kas ağrısını hafifletti. Ancak, her iki masaj müdahalesi de egzersiz sonrası kavrama kuvveti toparlanmasına katkı sağlamadı.
... Previous studies including cryotherapy [5], electrotherapy [6], stretching [7], antiinflammatory drugs [8], ultrasound [5], hyperbaric oxygen therapy [9], acupuncture [10], taping [7] and massage [11] to alleviate DOMS and to restore muscle function have reported conflicting results. Massage has been widely used in recovery of athletes from exercise and rehabilitation of patients for years. ...
The use of physical agent modalities dates back to the early days in the development of the field of physical and rehabilitation medicine. The term physiatrist is derived from the Greek words physis, pertaining to physical phenomena, and iatreia, referring to healer or physician. Thus a physiatrist is a physician who uses physical agents to relieve a patient's discomfort. Modalities are physical agents used to produce desired therapeutic effect. They include cold, heat, sound, electromagnetic waves, electricity, and mechanical forces. In this chapter, their physiologic effects, indications, techniques, and precautions are reviewed and discussed. Acupuncture and moxibustion, which use needling and heat to produce therapeutic effect, are also included. Physical agent modalities, although generally considered adjunctive rather than curative treatments, are widely used and important in the daily practices of most physiatrists.
This study evaluated a visual analog scale (VAS) and a graphic rating scale (GRS) for the measurement of pain following delayed onset muscle soreness (DOMS) and following treatment for the symptoms of DOMS. Data from two studies were used to evaluate the scales. Pain intensity was assessed prior to and following induction of DOMS and immediately before and after each treatment session. In Study 1, subjects were randomly assigned to receive a 20-min ice pack followed by a 7-min sham ultrasound treatment or a 20-min ice pack followed by a 7-min nonthermal ultrasound treatment. In Study 2, subjects received a 20-min microcurrent neuromuscular stimulation (MENS) treatment or a 20-min sham MENS treatment. In both studies, significant differences were found between the VAS and GRS scales for pretest conditions on Days 1 and 2 for all subjects. There were no significant differences between any other days or tests. The differences on Day 1 and Day 2 were attributed to the novelty of filling out the scales. Therefore, a visual analog or graphic rating scale can be used to evaluate pain intensity following DOMS when repeated measurement is involved, although consideration should be given to potential differences the first one or two times the scales are completed.
Eccentric exercise continues to receive attention as a productive means of exercise. Coupled with this has been the heightened study of the damage that occurs in early stages of exposure to eccentric exercise. This is commonly referred to as delayed onset muscle soreness (DOMS). To date, a sound and consistent treatment for DOMS has not been established. Although multiple practices exist for the treatment of DOMS, few have scientific support. Suggested treatments for DOMS are numerous and include pharmaceuticals, herbal remedies, stretching, massage, nutritional supplements, and many more. DOMS is particularly prevalent in resistance training; hence, this article may be of particular interest to the coach, trainer, or physical therapist to aid in selection of efficient treatments. First, we briefly review eccentric exercise and its characteristics and then proceed to a scientific and systematic overview and evaluation of treatments for DOMS. We have classified treatments into 3 sections, namely, pharmacological, conventional rehabilitation approaches, and a third section that collectively evaluates multiple additional practiced treatments. Literature that addresses most directly the question regarding the effectiveness of a particular treatment has been selected. The reader will note that selected treatments such as anti-inflammatory drugs and antioxidants appear to have a potential in the treatment of DOMS. Other conventional approaches, such as massage, ultrasound, and stretching appear less promising.
A fresh look at physiology is needed to better understand the primary medical complaint of pain. Universities are still teaching their students that life is based on a chemical model. Rather than view life processes on a chemical basis alone, it is more realistic to view them on an electrochemical basis. All atoms are bonded electrically. This is a basic foundation necessary to understand electromedicine that is taught during the most elementary training in the basic sciences. Further in our rudimentary training we learned that there are voltage potentials across the membrane of all cells. All standard physiology textbooks define the Nernst and Goldman Equations to determine membrane and action potentials. They do not, however, speculate on the staggering significance of these facts.
The visual analog scale (VAS) is a tool widely used to measure pain, yet controversy surrounds whether the VAS score is ratio or ordinal data. We studied 52 postoperative patients and measured their pain intensity using the VAS. We then asked them to consider different amounts of pain (conceptually twice as much and then half as much) and asked them to repeat their VAS rating after each consideration (VAS2 and VAS3, respectively). Patients with unrelieved pain had their pain treated with IV fentanyl and were then asked to rate their pain intensity when they considered they had half as much pain. We compared the baseline VAS (VAS1) with VAS2 and VAS3. The mean (95% confidence interval) for VAS2:1 was 2.12 (1.81–2.43) and VAS3:1 was 0.45 (0.38–0.52). We conclude that the VAS is linear for mild-to-moderate pain, and the VAS score can be treated as ratio data.
Implications: A change in the visual analog scale score represents a relative change in the magnitude of pain sensation. Use of the VAS in comparative analgesic trials can now meaningfully quantify differences in potency and efficacy.
This study evaluated the effectiveness of ibuprofen in treating delayed onset muscle soreness (DOMS) of the elbow flexors when taken prior to and following exercise. Twenty subjects received either 2,400 mg/day ibuprofen or a placebo four times per day. Subjects performed intense eccentric exercise of the elbow flexors to elicit DOMS. Concentric and eccentric peak torque production against an isokinetic resistance of 0.52 rad/s, range of motion at the elbow, and subjective soreness of the elbow flexors were measured. ANOVA indicated no significant group-by-time interaction for concentric peak torque, eccentric peak torque, or pain. A significant interaction was revealed for range of motion. There was a significant difference within each group's ROM but no interaction between groups. It was concluded that the use of 2,400 mg/day ibuprofen prior to and following intense eccentric exercise was no more effective than a placebo in treating DOMS of the elbow flexors.
See how energy therapies can normalize physiology and restore your patients' health! Energy Medicine: The Scientific Basis, 2nd Edition provides a deeper understanding of energy and energy flow in the human body. Using well-established scientific research, this book documents the presence of energy fields, discerns how those fields are generated, and determines how they are altered by disease, disorder, or injury. It then describes how therapeutic applications can restore natural energy flows within the body. Written by recognized energy medicine expert Dr. James Oschman - who is also a physiologist, cellular biologist, and biophysicist - this resource shows how the science of energetics may be used in healing diseases that conventional medicine has difficulty treating.
Delayed onset muscle soreness (DOMS) is a sensation of discomfort that occurs 1 to 2 days after exercise. The soreness has been reported to be most evident at the muscle/tendon junction initially, and then spreading throughout the muscle. The muscle activity which causes the most soreness and injury to the muscle is eccentric activity. The injury to the muscle has been well described but the mechanism underlying the injury is not fully understood. Some recent studies have focused on the role of the cytoskeleton and its contribution to the sarcomere injury.
Although little has been confirmed regarding the mechanisms involved in the production of delayed muscle soreness, it has been suggested that the soreness may occur as a result of mechanical factors or it may be biochemical in nature. To date, there appears to be no relationship between the development of soreness and the loss of muscle strength, in that the timing of the two events is different. Loss of muscle force has been observed immediately after the exercise. However, by collecting data at more frequent intervals a second loss of force has been reported in mice 1 to 3 days post-exercise. Future studies with humans may find this second loss of force to be related to DOMS.
The role of inflammation during exercise-induced muscle injury has not been clearly defined. It is possible that the inflammatory response may be responsible for initiating, amplifying, and/or resolving skeletal muscle injury. Evidence from the literature of the involvement of cytokines, complement, neutrophils, monocytes and macrophages in the acute phase response are presented in this review.
Clinically, DOMS is a common but self-limiting condition that usually requires no treatment. Most exercise enthusiasts are familiar with its symptoms. However, where a muscle has been immobilised or debilitated, it is not known how that muscle will respond to exercise, especially eccentric activity.