Effect of a single administration of focused extracorporeal shock wave in the relief of Delayed-Onset Muscle Soreness: results of a partially-blinded randomized controlled trial.

Author: Fleckenstein J1, Friton M2, Himmelreich H2, Banzer W2
Affiliation: <sup>1</sup>Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Germany; Department of TCM/Acupuncture, Institute of Complementary Medicine, University of Bern, Switzerland. Electronic address: johannes.fleckenstein@sportuni-frankfurt.de. <sup>2</sup>Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Germany.
Conference/Journal: Arch Phys Med Rehabil.
Date published: 2016 Dec 16
Other: Pages: S0003-9993(16)31307-7 , Special Notes: doi: 10.1016/j.apmr.2016.11.013. [Epub ahead of print] , Word Count: 309


OBJECTIVES: To examine the effects of a single administration of focused extracorporeal shockwave therapy (fESWT) on eccentric exercise-induced delayed-onset muscle soreness (DOMS). DOMS is a common symptom in people participating in exercise, sports, or recreational physical activities.

DESIGN: Three-arm randomized controlled study conducted in 2009.

SETTING: DOMS was induced by eccentric exercise of the non-dominant arm in voluntary participants at the Sports Campus of a German university.

INTERVENTIONS: Participants were randomly allocated to verum (energy flux density 0.06 to 0.09 mJ/mm2; pulse ratio per point 200), or sham fESWT (no energy) at 7 equidistant points along the biceps muscle, or no intervention.

MAIN OUTCOME MEASURE: The primary outcome was the difference in pain intensity. Secondary outcomes included maximum isometric voluntary force (MIVF), pressure pain threshold (PPT) and impairment in daily life.

RESULTS: DOMS was induced in 46 participants (23 female) with a mean age of 29.0 years (standard deviation [SD] = 3.0) and a mean BMI of 23.8 kg/m2 (SD = 2.8). Despite descriptive clinically meaningful differences, mixed-effects analysis (group x time) of changes to baseline did not reveal significant differences in the reduction of pain intensity between groups (F2.498, df2, p = 0.094). The MIVF was not significantly different between groups (F1.917, df2, p = 0.159). The PTT was not significantly decreased over time (F0.158, df2, p = 0.854), as was the daily life impairment (F1.444, df2, p = 0.248), and there were no differences between groups in the post-hoc analysis.

CONCLUSIONS: A single treatment with fESWT causes clinically relevant effects in the relief of pain, increase in force, and improvement of pain-associated impairments of daily living. Still, results need to be cautiously interpreted due to the pilot character of this study. Focused ESWT might present an option in the mid-term recovery from DOMS (72 hours). This being an approach enhancing the return to play in athletes.

Copyright © 2016. Published by Elsevier Inc.

KEYWORDS: inflammation; integrative medicine; muscle pain; peripheral nociception; return to play; shockwave

PMID: 27993588 DOI: 10.1016/j.apmr.2016.11.013