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Efficacy of cryoflow therapy in induced muscle soreness: a randomized trial

Abstract

Background

An individual experiencing delayed-onset muscle soreness notices pain and aching within the affected muscles, decreased range of motion, and loss in muscle strength beginning 12–24 h after exercise, peaking between 48 and 72 h, and subsiding within 5–7 days after exercise. The aim of this study was to investigate the effect of locally applied cryoflow therapy on pain and function in induced muscle soreness of nondominant elbow flexors.

Participants and methods

Sixty healthy individuals participated in this study. They were divided randomly into two groups, 30 in each group. Pre-exercise measures were recorded for pressure pain threshold using a pressure algometer and level of limitation using Patient-Rated Elbow Evaluation. Participants performed free-weight curl exercises until fatigue using a 10-lb dumbbell at a tempo of 1 s for the concentric phase and 3 s for the eccentric phase to induce muscle soreness. Group A underwent cryoflow therapy administered immediately after exercise using a ShockMaster ICE-CT cryotherapy device at 12°C for 10 min once a day for 4 days. Group B underwent cold treatment using a flexible gel pack for 10 min once a day for 4 days. Dependent variables were assessed at 0, 24, 48, and 72 h after exercise.

Results

Statistically significant differences were found between both groups for pain using pressure threshold and pain level of the Patient-Rated Elbow Evaluation scale at 48 and 72 h (P = 0.01, 0.002, and 0.0006, 0.0001, respectively); for the functional scale, statistically significant differences were found only at 72 h (P = 0.0001).

Conclusion

Cryoflow therapy was superior in overcoming delayed-onset muscle soreness than the use of a cryogel pack in case of induced muscle soreness.

References

  1. Sunitha J. Cryotherapy –a review. J Clin Diagn Res 2010; 4:2325–2329.

    Google Scholar 

  2. Wilcock IM, Cronin JB, Hing WA. Physiological response to water immersion: a method for sport recovery? Sports Med 2006; 36:747–765.

    Google Scholar 

  3. White E, Wells D. Cold-water immersion and other forms of cryotherapy: physiological changes potentially affecting recovery from high-intensity exercise. Extrem Physiol Med 2013; 2:26–37.

    Article  Google Scholar 

  4. William JR, Srikantaiah, S, Mani, R. Cryotherapy for acute non-specific neck pain. Cochrane Database Syst Rev 2013; 8:CD010711.

    Google Scholar 

  5. Banfi G, Lombardi G, Colombini A, Melegati G. Whole-body cryotherapy in athletes. Sports Med 2010; 40:509–517.

    Article  Google Scholar 

  6. Tee JC, Bosch AN, Lambert MI. Metabolic consequences of exercise-induced muscle damage. Sports Med 2007; 37:827–836.

    Article  Google Scholar 

  7. Adams GR, Zaldivar FP, Nance DM, Kodesh E, Radom-Aizik S, Cooper DM. Exercise and leukocyte interchange among central circulation, lung, spleen, and muscle. Brain Behav Immun 2011; 25:658–666.

    Article  Google Scholar 

  8. Kendall BR. Exercise-induced muscle damage and the potential protective role of estrogen. Sports Med 2002; 32:103–123.

    Article  Google Scholar 

  9. Tidball JG, Daniel TL. Elastic energy storage in rigored skeletal muscle cells under physiological loading conditions. Am J Physiol 1986; R56–64.

  10. Ascensão A, Leite M, Rebelo AN, Magalhäes S, Magalhäes J. Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match. J Sports Sci 2011; 29:217–225.

    Article  Google Scholar 

  11. Bakhtiary AH. Influence of vibration in delayed onset muscle soreness following eccentric exercise. Br J Sports Med 2007; 41:145–148.

    Article  Google Scholar 

  12. Barata P, Cervaens M, Resende R, Camacho Ó, Marques F. Hyperbaric oxygen effects on sports injuries. Ther Adv Musculoskelet Dis 2011; 3:111–121.

    Article  CAS  Google Scholar 

  13. Cannavino CR, Abrams J, Palinkas LA. Efficacy of transdermal ketoprofen for delayed onset muscle soreness. Clin J Sport Med 2003; 13:200–208.

    Article  Google Scholar 

  14. Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness: treatment strategies and performance factors. Sports Med 2003; 33:145–164.

    Article  Google Scholar 

  15. Nemet D, Meckel Y, Bar-Sela S, Zaldivar F, Cooper DM, Eliakim A. Effect of local cold-pack application on systemic anabolic and inflammatory response to sprint-interval training: a prospective comparative trial. Eur J Appl Physiol 2009; 107:411–417.

    Article  Google Scholar 

  16. Ranjan R, Mitra PK, Kumar R, Kumar S, Ghosh DP. The effect of cryoflow (ir guided) as a component of comprehensive treatment in shoulder pain. JODMSE 2013; 1:1–13.

    Google Scholar 

  17. Fuentes CJ, Armijo Olivo S, Magee DJ, Gross DP. A preliminary investigation into the effects of active interferential current therapy and placebo on pressure pain sensitivity: a random crossover placebo controlled study. Physiotherapy 2011; 97:291–301.

    Article  Google Scholar 

  18. Antonaci F, Sand T, Lucas GA. Pressure algometry in healthy subjects: inter-examiner variability. Scand J Rehabil Med 1998; 30:3–8.

    Article  CAS  Google Scholar 

  19. Dannecker EA, Sluka KA. Pressure and activity-related allodynia in delayed-onset muscle pain. Clin J Pain 2011; 27:42.

    Article  Google Scholar 

  20. Vincent J, MacDermid JC. The Patient-Rated Elbow Evaluation (PREE). J Physiother 2012; 58:274.

    Article  Google Scholar 

  21. Howatson G, Van Someren KA. The prevention and treatment of exercise-induced muscle damage. Sports Med 2008; 38:483–503.

    Article  Google Scholar 

  22. John M, Angst F, Pap G, Junge A, Mannion AF. Cross-cultural adaptation, reliability and validity of the Patient Rated Elbow Evaluation (PREE) for German-speaking patients. Clin Exp Rheumatol 2007; 25:195–205.

    CAS  Google Scholar 

  23. Day M, Ploen E. The effectiveness of cryotherapy in the treatment of exercise-induced muscle soreness. UW-L Journal of Undergraduate Research 2010; 13:1–6.

    Google Scholar 

  24. Malm C. Leukocytes, cytokines, growth factors and hormones in human skeletal muscle and blood after uphill or downhill running. J Physiol 2004; 556:983–1000.

    Article  CAS  Google Scholar 

  25. Jones DH, Kilgour RD, Comtois AS. Test–retest reliability of pressure pain threshold measurements of the upper limb and torso in young healthy woman. J Pain 2007; 8:650–656.

    Article  Google Scholar 

  26. Marieb EN. Human anatomy & physiology. 6th ed. San Francisco: Pearson Education Inc.; 2004. 298–303.

    Google Scholar 

  27. Kachanathu SJ, Kumar M, Jaiswal P, Nuhmani S, Vellappally S. A comparative study on cryo, pulsed ultrasound and its combination therapies on delayed onset of muscle soreness. Int J Med Res Health Sci 2013; 2:786–792.

    Article  Google Scholar 

  28. Karbalaeifar S, Nobahar M, Behpoor N, Esmaeili G. The comparison of surface heat and cold effects on the some signs of delayed onset muscle soreness. Ann Biol Res 2012; 3:2168–2172.

    Google Scholar 

  29. Oakley ET, Pardeiro RB, Powell JW, Millar AL. The effects of multiple daily applications of ice to the hamstrings on biochemical measures, signs, and symptoms associated with exercise-induced muscle damage. J Strength Cond Res 2013; 27:2743–2751.

    Article  Google Scholar 

  30. Chesterton LS, Sim J, Wright CC, Foster NE. Inter-rater reliability of algometry in measuring pressure pain thresholds in healthy humans, using multiple raters. Clin J Pain 2007; 23:760–766.

    Article  Google Scholar 

  31. Gregson W, Black MA, Jones H, Milson J, Morton J, Dawson B, Green DJ. Influence of cold water immersion on limb and cutaneous blood flow at rest. Am J Sports Med 2011; 39:1316–1323.

    Article  Google Scholar 

  32. Howatson G, Gaze D, Van Someren KA. The efficacy of ice massage in the treatment of exercise-induced muscle damage. Scand J Med Sci Sports 2005; 15:416–422.

    Article  CAS  Google Scholar 

  33. Sellwood K, Brukner P, Williams D, Nicol A, Hinman R. Ice-water immersion and delayed-onset muscle soreness: a randomized controlled trial. Br J Sports Med 2007; 41:392–397.

    Article  Google Scholar 

  34. Torres R, Ribeiro F, Alberto Duarte J, Cabri JM. Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: systematic review and meta-analysis. Phys Ther Sport 2012; 13:101–114.

    Article  Google Scholar 

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Correspondence to Salah Eldin B. Elsayed.

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Elsayed, S.E.B., Raoof, N.A.A. & Abdallah, N.S. Efficacy of cryoflow therapy in induced muscle soreness: a randomized trial. Bull Fac Phys Ther 20, 137–145 (2015). https://doi.org/10.4103/1110-6611.174692

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  • DOI: https://doi.org/10.4103/1110-6611.174692

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