Efficacy of the Most Commonly Used Physiotherapeutic Treatments for Acute Lower Limb Fatigue in Athletes
NCT ID: NCT05167162
Last Updated: 2024-08-12
Study Results
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Basic Information
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COMPLETED
NA
80 participants
INTERVENTIONAL
2021-11-06
2022-04-30
Brief Summary
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Keywords: Lower limbs, physiotherapy, athlete, biomechanics, protocol.
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Detailed Description
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Acute fatigue is the inability to generate a required or expected level of exercise force or intensity, whether or not preceded by previous exercise. Acute fatigue is an important risk factor in overuse injuries. It is multifactorial in nature and its mechanisms of formation are imprecise. This type of fatigue can affect both the peripheral level, generating neuromuscular or peripheral fatigue, and the central level, generating central fatigue. Peripheral or neuromuscular fatigue is the result of altered musculoskeletal homeostasis due to a limitation or failure of one or more motor unit processes, producing a dysfunction in the contraction process. Central fatigue is an involuntary failure in brain function or nerve impulse conduction, resulting in impaired transmission from the central nervous system (CNS) and impaired motor axon recruitment. One of the main factors associated with central fatigue is the alteration of synthesis and activity of some neurotransmitters.
Elite athletes push their training to the limit in order to maximize their performance. This generates muscle damage that results in a breakdown of structural proteins of muscle fibers and connective tissues, causing tissue inflammation, Delayed Onset Muscle Soreness (DOMS) and an increase in perceived fatigue. To maximize an athlete's ability to perform, it is not only the training that must be addressed, but also the balance between training and recovery. This prevents maladaptation to physiological and psychological stresses induced by the load. Therefore, it is important for the athlete to optimize the recovery period to reduce the risk of injury.
The purpose of this research is to demonstrate the efficacy of various physiotherapeutic protocols, analyzing the degree of effectiveness in each of these for recovery from acute fatigue in athletes.
Conditions
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Study Design
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RANDOMIZED
CROSSOVER
Group 1: Compression techniques (n=20). Group 2: Massage techniques (n=20) Group 3: Hydrotherapy (n=20) Group 4: Active recovery technique (n=20)
TREATMENT
TRIPLE
Study Groups
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Group 1: Compression technique
20 participants make up the compression technique group.
State-Trait Anxiety Questionnaire
The scale measures ordinally (1 to 5) the values observed during exposure to anxiety patterns during exercise, such as higher repetitions, greater weight gain or longer exercise duration, as follows:
1. Not at all
2. Little
3. Sometimes
4. Almost always
5. Always
Rating of Perceived Exertion
The scale measures in ordinal form (1 to 6) the perceived effort during the exercise as follows:
1. No pain
2. Little pain
3. Moderate
4. Severe
5. Very strong
6. Unbearable
Motor coordination tests
The motor coordination tests are divided into three:
1. Jumping with 2 feet together.
2. Throwing 2 balls from a given distance and space.
3. Proprioception turns
Physiotherapeutic intervention
Participants received one session per week, until a total of 20 sessions were completed: Group 1 (n=20) received the muscle compression treatment. Group 2 (n=20) received the manual massage treatment. Group 3 (n=20) received the hydrotherapy treatment and group 4 (n=20) received the active recovery treatment.
Data Analysis
The usual descriptive parameters (mean and standard deviation) of the sample were calculated. The distribution and analysis of the other data were performed by means of a nonparametric test (Mann-Whitney U test) comparing the groups. A confidence level of 95% was established, considering a value of p\<0.05 as statistically significant.
Group 2: Massage techniques
20 participants make up the massage technique group.
State-Trait Anxiety Questionnaire
The scale measures ordinally (1 to 5) the values observed during exposure to anxiety patterns during exercise, such as higher repetitions, greater weight gain or longer exercise duration, as follows:
1. Not at all
2. Little
3. Sometimes
4. Almost always
5. Always
Rating of Perceived Exertion
The scale measures in ordinal form (1 to 6) the perceived effort during the exercise as follows:
1. No pain
2. Little pain
3. Moderate
4. Severe
5. Very strong
6. Unbearable
Motor coordination tests
The motor coordination tests are divided into three:
1. Jumping with 2 feet together.
2. Throwing 2 balls from a given distance and space.
3. Proprioception turns
Physiotherapeutic intervention
Participants received one session per week, until a total of 20 sessions were completed: Group 1 (n=20) received the muscle compression treatment. Group 2 (n=20) received the manual massage treatment. Group 3 (n=20) received the hydrotherapy treatment and group 4 (n=20) received the active recovery treatment.
Data Analysis
The usual descriptive parameters (mean and standard deviation) of the sample were calculated. The distribution and analysis of the other data were performed by means of a nonparametric test (Mann-Whitney U test) comparing the groups. A confidence level of 95% was established, considering a value of p\<0.05 as statistically significant.
Group 3: Hydromassage
20 participants make up the hydromassage technique group.
State-Trait Anxiety Questionnaire
The scale measures ordinally (1 to 5) the values observed during exposure to anxiety patterns during exercise, such as higher repetitions, greater weight gain or longer exercise duration, as follows:
1. Not at all
2. Little
3. Sometimes
4. Almost always
5. Always
Rating of Perceived Exertion
The scale measures in ordinal form (1 to 6) the perceived effort during the exercise as follows:
1. No pain
2. Little pain
3. Moderate
4. Severe
5. Very strong
6. Unbearable
Motor coordination tests
The motor coordination tests are divided into three:
1. Jumping with 2 feet together.
2. Throwing 2 balls from a given distance and space.
3. Proprioception turns
Physiotherapeutic intervention
Participants received one session per week, until a total of 20 sessions were completed: Group 1 (n=20) received the muscle compression treatment. Group 2 (n=20) received the manual massage treatment. Group 3 (n=20) received the hydrotherapy treatment and group 4 (n=20) received the active recovery treatment.
Data Analysis
The usual descriptive parameters (mean and standard deviation) of the sample were calculated. The distribution and analysis of the other data were performed by means of a nonparametric test (Mann-Whitney U test) comparing the groups. A confidence level of 95% was established, considering a value of p\<0.05 as statistically significant.
Group 4: Active recovery technique.
20 participants make up the active recovery technique group.
State-Trait Anxiety Questionnaire
The scale measures ordinally (1 to 5) the values observed during exposure to anxiety patterns during exercise, such as higher repetitions, greater weight gain or longer exercise duration, as follows:
1. Not at all
2. Little
3. Sometimes
4. Almost always
5. Always
Rating of Perceived Exertion
The scale measures in ordinal form (1 to 6) the perceived effort during the exercise as follows:
1. No pain
2. Little pain
3. Moderate
4. Severe
5. Very strong
6. Unbearable
Motor coordination tests
The motor coordination tests are divided into three:
1. Jumping with 2 feet together.
2. Throwing 2 balls from a given distance and space.
3. Proprioception turns
Physiotherapeutic intervention
Participants received one session per week, until a total of 20 sessions were completed: Group 1 (n=20) received the muscle compression treatment. Group 2 (n=20) received the manual massage treatment. Group 3 (n=20) received the hydrotherapy treatment and group 4 (n=20) received the active recovery treatment.
Data Analysis
The usual descriptive parameters (mean and standard deviation) of the sample were calculated. The distribution and analysis of the other data were performed by means of a nonparametric test (Mann-Whitney U test) comparing the groups. A confidence level of 95% was established, considering a value of p\<0.05 as statistically significant.
Interventions
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State-Trait Anxiety Questionnaire
The scale measures ordinally (1 to 5) the values observed during exposure to anxiety patterns during exercise, such as higher repetitions, greater weight gain or longer exercise duration, as follows:
1. Not at all
2. Little
3. Sometimes
4. Almost always
5. Always
Rating of Perceived Exertion
The scale measures in ordinal form (1 to 6) the perceived effort during the exercise as follows:
1. No pain
2. Little pain
3. Moderate
4. Severe
5. Very strong
6. Unbearable
Motor coordination tests
The motor coordination tests are divided into three:
1. Jumping with 2 feet together.
2. Throwing 2 balls from a given distance and space.
3. Proprioception turns
Physiotherapeutic intervention
Participants received one session per week, until a total of 20 sessions were completed: Group 1 (n=20) received the muscle compression treatment. Group 2 (n=20) received the manual massage treatment. Group 3 (n=20) received the hydrotherapy treatment and group 4 (n=20) received the active recovery treatment.
Data Analysis
The usual descriptive parameters (mean and standard deviation) of the sample were calculated. The distribution and analysis of the other data were performed by means of a nonparametric test (Mann-Whitney U test) comparing the groups. A confidence level of 95% was established, considering a value of p\<0.05 as statistically significant.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Presentation of typical clinical signs of acute fatigue in one of the two lower limbs
* Positive diagnosis of acute fatigue
Exclusion Criteria
* Healthy athletes
* Diagnosed injuries other than acute fatigue
20 Years
25 Years
ALL
No
Sponsors
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Clinica Gema Leon
OTHER
Responsible Party
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GEMA LEÓN BRAVO
Principal Investigator
Principal Investigators
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Gema León Bravo, Physiotherap
Role: PRINCIPAL_INVESTIGATOR
Gema León Physiotherapy and Rehabilitation Clinic
Rafael Arenas Quiles, Physiotherap
Role: STUDY_CHAIR
Universidad de Córdoba
Locations
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Gema León Physiotherapy and Rehabilitation Clinic
Córdoba, Andalusia, Spain
Countries
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References
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Benjaminse A, Webster KE, Kimp A, Meijer M, Gokeler A. Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses. Sports Med. 2019 Apr;49(4):565-586. doi: 10.1007/s40279-019-01052-6.
Guan Y, Bredin S, Jiang Q, Taunton J, Li Y, Wu N, Wu L, Warburton D. The effect of fatigue on asymmetry between lower limbs in functional performances in elite child taekwondo athletes. J Orthop Surg Res. 2021 Jan 9;16(1):33. doi: 10.1186/s13018-020-02175-7.
Burton I. Autoregulation in Resistance Training for Lower Limb Tendinopathy: A Potential Method for Addressing Individual Factors, Intervention Issues, and Inadequate Outcomes. Front Physiol. 2021 Aug 5;12:704306. doi: 10.3389/fphys.2021.704306. eCollection 2021.
Trojian T, Driban J, Nuti R, Distefano L, Root H, Nistler C, LaBella C. Osteoarthritis action alliance consensus opinion - best practice features of anterior cruciate ligament and lower limb injury prevention programs. World J Orthop. 2017 Sep 18;8(9):726-734. doi: 10.5312/wjo.v8.i9.726. eCollection 2017 Sep 18.
Franke TPC, Backx FJG, Huisstede BMA. Lower extremity compression garments use by athletes: why, how often, and perceived benefit. BMC Sports Sci Med Rehabil. 2021 Mar 24;13(1):31. doi: 10.1186/s13102-020-00230-8.
Ghram A, Young JD, Soori R, Behm DG. Unilateral Knee and Ankle Joint Fatigue Induce Similar Impairment to Bipedal Balance in Judo Athletes. J Hum Kinet. 2019 Mar 27;66:7-18. doi: 10.2478/hukin-2018-0063. eCollection 2019 Mar.
Cejudo A, Sainz de Baranda P, Ayala F, De Ste Croix M, Santonja-Medina F. Assessment of the Range of Movement of the Lower Limb in Sport: Advantages of the ROM-SPORT I Battery. Int J Environ Res Public Health. 2020 Oct 19;17(20):7606. doi: 10.3390/ijerph17207606.
DeLang MD, Salamh PA, Farooq A, Tabben M, Whiteley R, van Dyk N, Chamari K. The dominant leg is more likely to get injured in soccer players: systematic review and meta-analysis. Biol Sport. 2021 Sep;38(3):397-435. doi: 10.5114/biolsport.2021.100265. Epub 2020 Oct 28.
Gilbert FC, Burdette GT, Joyner AB, Llewellyn TA, Buckley TA. Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes. Sports Health. 2016 Nov/Dec;8(6):561-567. doi: 10.1177/1941738116666509. Epub 2016 Sep 20.
Drury B, Ratel S, Clark CCT, Fernandes JFT, Moran J, Behm DG. Eccentric Resistance Training in Youth: Perspectives for Long-Term Athletic Development. J Funct Morphol Kinesiol. 2019 Nov 28;4(4):70. doi: 10.3390/jfmk4040070.
Mang CS, Whitten TA, Cosh MS, Dukelow SP, Benson BW. Assessment of Postural Stability During an Upper Extremity Rapid, Bimanual Motor Task After Sport-Related Concussion. J Athl Train. 2020 Nov 1;55(11):1160-1173. doi: 10.4085/1062-6050-378-19.
Avedesian JM, Covassin T, Dufek JS. The Influence of Sport-Related Concussion on Lower Extremity Injury Risk: A Review of Current Return-to-Play Practices and Clinical Implications. Int J Exerc Sci. 2020 Aug 1;13(3):873-889. doi: 10.70252/WVYL1782. eCollection 2020.
Frutuoso AS, Diefenthaeler F, Vaz MA, Freitas Cde L. LOWER LIMB ASYMMETRIES IN RHYTHMIC GYMNASTICS ATHLETES. Int J Sports Phys Ther. 2016 Feb;11(1):34-43.
Siupsinskas L, Garbenyte-Apolinskiene T, Salatkaite S, Gudas R, Trumpickas V. Association of pre-season musculoskeletal screening and functional testing with sports injuries in elite female basketball players. Sci Rep. 2019 Jun 26;9(1):9286. doi: 10.1038/s41598-019-45773-0.
Dubose DF, Herman DC, Jones DL, Tillman SM, Clugston JR, Pass A, Hernandez JA, Vasilopoulos T, Horodyski M, Chmielewski TL. Lower Extremity Stiffness Changes after Concussion in Collegiate Football Players. Med Sci Sports Exerc. 2017 Jan;49(1):167-172. doi: 10.1249/MSS.0000000000001067.
Beck B, Drysdale L. Risk Factors, Diagnosis and Management of Bone Stress Injuries in Adolescent Athletes: A Narrative Review. Sports (Basel). 2021 Apr 16;9(4):52. doi: 10.3390/sports9040052.
Other Identifiers
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ART-GLB-ACUTE FATIGUE
Identifier Type: -
Identifier Source: org_study_id
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