Massage intervention for exercise-induced muscle damage
Exhaustive and/or unaccustomed exercise, mainly involving eccentric muscle actions, induces temporary muscle damage, evidenced by delayed onset muscle soreness (DOMS) and decreased muscle function. Different strategies to recover from its signs and symptoms have been studied and, as a result, a significant number of articles on this issue have been published. The team from Portugal carried out a review to assess whether some modalities currently used in physiotherapy such as massage, cryotherapy, stretching and low-intensity exercise are effective for treating the signs and symptoms of exercise-induced muscle damage. The results were published in Physical Therapy Sports May 2012, Vol. 13(2), pages 101-114.
The authors searched through Randomized controlled trials (RCTs), written in English or Portuguese, that included physiotherapeutic interventions [i.e., massage, cryotherapy, stretching and low-intensity exercise, on adult human subjects (18-60 years old) of both gender] were searched on electronic databases. "Muscle soreness" and "muscle strength" were the outcome measures included in the meta-analysis.
The authors included thirty-five studies; nine analysed the effects of massage, 10 examined the effects of cryotherapy, nine investigated the effects of stretching and seven focused on low-intensity exercise intervention.
The authors found that Massage was the only intervention with positive effects, reducing soreness at 24 h, on average, 0.33 on 10 cm visual analog scale and increasing muscle recovery by 1.87 percent. Additionally, there is inconclusive evidence to support the use of cryotherapy, while there is little evidence to prove the efficacy of stretching and low-intensity exercise.
The authors concluded that Massage proved slightly effective in the relief of symptoms and signs of exercise-induced muscle damage. However, its mean effect was too small to be of clinical relevance. There is a lack of evidence to support the use of cryotherapy, stretching and low-intensity exercise.
Development and application of an instrument for deep cross-friction massage in chronic non-specific low back pain
Researchers from Department of Rehabilitation Medicine, Jesus Hospital, in Korea developed a massage instrument, the Hand Grip T-bar (HT-bar) and used it to relieve chronic non-specific low back pain (nLBP) through deep cross-friction massage (roptrotherapy).
22 subjects (9 males and 13 females, mean age 52 ± 7 years) with chronic nLBP were allocated randomly to a Roptrotherapy group and a Transcutaneous Electrical Nerve Stimulation (TENS) group. The Roptrotherapy group received deep cross-friction massage with the HT-bar, which was made of metal and had a cylinder for increasing weight and grooves for an easy grip. It was applied across the middle and lower back for 20 minutes a day, 3 days a week for 2 weeks. The TENS group received TENS for 20 minutes a day, 5 days a week for 2 weeks. The outcome was measured on the pain numeric rating scale (PNRS), by the Oswestry disability index (ODI), and by the Roland & Morris Disability Questionnaire (RMDQ) at pre-treatment, at immediate post-treatment and 2 weeks later. The application of the HT-bar was assessed by a questionnaire to 19 therapists.
At post-treatment, immediately and 2 weeks later, both groups showed significant improvement in PNRS pain scale, ODI and RMDQ disability index. During the two weeks after post-treatment, however, the Roptrotherapy group improved in all pain and disability index, while the TENS group did not. Over 80% of the therapists responded that the HT-bar was useful and comfortable.
The authors suggested that deep cross-friction massage can be a beneficial therapeutic technique and that the HT-bar can be a useful instrument in deep cross-friction massage for chronic nLBP patients.
The effect of abdominal massage on gastric residual volume
This study from nursing department in Turkey is aimed at determining the effects of abdominal massage on high gastric residual volume seen in patients intermittently fed with enteral nutrition through a nasogastric tube. The study, a randomized controlled trial, also investigated consequent abdominal distension and vomiting complications. The study was carried out in a university hospital between January and December 2009.
The sample included 40 intervention (abdominal massage) and 40 control subjects. Findings demonstrated that 2.5% of the subjects in the massage group and 30% of the subjects in the control group developed high gastric residual volume from enteral nutrition through a nasogastric tube.
Abdominal circumference measurements of subjects on the first and last days demonstrated that 20% of the subjects in the control group and only 2.5% of the subjects in the massage group developed abdominal distension. Vomiting was observed in 10% of the control subjects; no vomiting was observed in the intervention group. The findings suggest that nurses should apply abdominal massage to subjects receiving enteral feedings intermittently to prevent high gastric residual volume and abdominal distension.
Gastroenterol Nurs. 2012 Mar;35(2):117-23.
Knee injuries in women linked to motion and nervous system differences
Women are more prone to knee injuries than men, and the findings of a new study suggest this may involve more than just differences in muscular and skeletal structure – it shows that males and females also differ in the way they transmit the nerve impulses that control muscle force.
Scientists at Oregon State University found that men control nerve impulses similar to individuals trained for explosive muscle usage – like those of a sprinter – while the nerve impulses of women are more similar to those of an endurance-trained athlete, like a distance runner.
In particular, the research may help to explain why women tend to suffer ruptures more often than men in the anterior cruciate ligament of their knees during non-contact activities. These ACL injuries are fairly common, can be debilitating, and even when repaired can lead to osteoarthritis later in life.
“It’s clear that women move differently than men, but it’s not as obvious why that is,” said Sam Johnson, a clinical assistant professor in the OSU School of Biological and Population Health Sciences. “There are some muscular and skeletal differences between men and women, but that doesn’t explain differences in injury rates as much as you might think,” Johnson said. “No one has really studied the role of the nervous system the way we have in explaining these differences, specifically the way sensory information is processed and integrated with motor function in the spinal cord.”
In this study, just published in the European Journal of Applied Physiology, the scientists found that most aspects of spinal motor control and rapid activation of muscles were similar in 17 men and 17 women that were examined – with one exception. Men had a higher level of “recurrent inhibition,” which is a process in the spinal cord that helps select the appropriate muscle response.
Even a process as simple as walking is surprisingly complicated, as people process large amounts of information and use varying forces to move around obstacles, change direction or simply climb up a step. And when you slip on an icy patch, the need for extremely rapid and accurate muscle response might be all that stands between you and a broken hip.
For some reason, women tend to have knee motions that make them more susceptible to injury. Among other things, when landing from a jump their knees tend to collapse inward more than that of most men. They suffer significantly more ACL injuries during physical activity.
“We’re finding differences in nervous system processing that we believe are related to this,” Johnson said. “The causes for those differences are unclear, but it may be due either to a biological difference, such as hormones, or a cultural difference such as different exercise and training patterns.”
While researchers continue to study what might help address this, Johnson said it’s already possible for women to be more aware of these common differences and do exercises that should reduce problems. Many ACL injury prevention programs incorporate strength, balance, flexibility, and jump training. However, based on these and other findings, women – especially athletes – should consider training with motions more similar to those of their sport, such as squatting, lunging, jumping or cutting side-to-side.
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