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Does Acupuncture Benefit Delayed-Onset Muscle Soreness After Strenuous Exercise? A Systematic Review and Meta-Analysis.

ABSTRACT: Purpose: This systematic review and meta-analysis was designed to evaluate the effects of acupuncture intervention on alleviating delayed onset of muscle soreness (DOMS) after intense exercise. Method: Randomized controlled trials (RCTs) were searched from online databases including Medline (PubMed), Cochrane Library, Web of Science, Embase, PsycINFO, China Knowledge Resource Integrated Database (CNKI), and Wanfang (Chinese) up to April 2019. Data points were extracted from the eligible RCTs at the time points of 24, 48, and 72 h post strenuous exercise-induced DOMS. The outcomes of muscle soreness rating (MSR), creatine kinase (CK), and maximal isometric force (MIF) were pooled into the meta-analysis to assess the acupuncture intervention on DOMS. Results: Six eligible RCTs were included in the meta-analysis, and the results showed that acupuncture intervention significantly decreased MSR [standardized mean difference (SMD) -0.49, 95%CI -0.73 to -0.24, P < 0.001, I 2 = 34%] and the serum level of CK (SMD -0.91, 95%CI -1.27 to -0.56, P < 0.001, I 2 = 30%), accompanied with the improvement of the muscle strength (MIF) (SMD 0.54, 95%CI 0.16 to 0.93, P = 0.006, I 2 = 51%) after intense exercise. At the same time, the findings also revealed that acupuncture intervention had a long-lasting effect and tended to accumulate the effect size and that it had the most efficacy on alleviating DOMS at the time point of 72 h post exercise. Conclusion: The current evidence indicates that acupuncture intervention after intense exercise could be effective for alleviating DOMS and improving muscle recovery. The long-lasting effect of acupuncture intervention on DOMS started from 24 h and would reach a peak on the time point of 72 h post exercise.

SUBMITTER: Huang C

PROVIDER: S-EPMC7379881 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Does Acupuncture Benefit Delayed-Onset Muscle Soreness After Strenuous Exercise? A Systematic Review and Meta-Analysis.

Huang Chunwei C Wang Zhipeng Z Xu Xiaoling X Hu Shuangshuang S Zhu Rong R Chen Xi X

Frontiers in physiology 20200717

<b>Purpose:</b> This systematic review and meta-analysis was designed to evaluate the effects of acupuncture intervention on alleviating delayed onset of muscle soreness (DOMS) after intense exercise. <b>Method:</b> Randomized controlled trials (RCTs) were searched from online databases including Medline (PubMed), Cochrane Library, Web of Science, Embase, PsycINFO, China Knowledge Resource Integrated Database (CNKI), and Wanfang (Chinese) up to April 2019. Data points were extracted from the eli ...[more]

PMID: 32765287

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Project description:Background: Post-exercise (i.e., cool-down) stretching is commonly prescribed for improving recovery of strength and range of motion (ROM) and diminishing delayed onset muscular soreness (DOMS) after physical exertion. However, the question remains if post-exercise stretching is better for recovery than other post-exercise modalities. Objective: To provide a systematic review and meta-analysis of supervised randomized-controlled trials (RCTs) on the effects of post-exercise stretching on short-term (≤1 h after exercise) and delayed (e.g., ≥24 h) recovery makers (i.e., DOMS, strength, ROM) in comparison with passive recovery or alternative recovery methods (e.g., low-intensity cycling). Methods: This systematic review followed PRISMA guidelines (PROSPERO CRD42020222091). RCTs published in any language or date were eligible, according to P.I.C.O.S. criteria. Searches were performed in eight databases. Risk of bias was assessed using Cochrane RoB 2. Meta-analyses used the inverse variance random-effects model. GRADE was used to assess the methodological quality of the studies. Results: From 17,050 records retrieved, 11 RCTs were included for qualitative analyses and 10 for meta-analysis (n = 229 participants; 17-38 years, mostly males). The exercise protocols varied between studies (e.g., cycling, strength training). Post-exercise stretching included static stretching, passive stretching, and proprioceptive neuromuscular facilitation. Passive recovery (i.e., rest) was used as comparator in eight studies, with additional recovery protocols including low intensity cycling or running, massage, and cold-water immersion. Risk of bias was high in ~70% of the studies. Between-group comparisons showed no effect of post-exercise stretching on strength recovery (ES = -0.08; 95% CI = -0.54-0.39; p = 0.750; I 2 = 0.0%; Egger's test p = 0.531) when compared to passive recovery. In addition, no effect of post-exercise stretching on 24, 48, or 72-h post-exercise DOMS was noted when compared to passive recovery (ES = -0.09 to -0.24; 95% CI = -0.70-0.28; p = 0.187-629; I 2 = 0.0%; Egger's test p = 0.165-0.880). Conclusion: There wasn't sufficient statistical evidence to reject the null hypothesis that stretching and passive recovery have equivalent influence on recovery. Data is scarce, heterogeneous, and confidence in cumulative evidence is very low. Future research should address the limitations highlighted in our review, to allow for more informed recommendations. For now, evidence-based recommendations on whether post-exercise stretching should be applied for the purposes of recovery should be avoided, as the (insufficient) data that is available does not support related claims. Systematic Review Registration: PROSPERO, identifier: CRD42020222091.

Project description:Histamine contributes to elevations in skeletal muscle blood flow following exercise, which raises the possibility that histamine is an important mediator of the inflammatory response to exercise. We examined the influence of antihistamines on postexercise blood flow, inflammation, muscle damage, and delayed-onset muscle soreness (DOMS) in a model of moderate exercise-induced muscle damage. Subjects consumed either a combination of fexofenadine and ranitidine (blockade, n = 12) or nothing (control, n = 12) before 45 min of downhill running (-10% grade). Blood flow to the leg was measured before and throughout 120 min of exercise recovery. Markers of inflammation, muscle damage, and DOMS were obtained before and at 0, 6, 12, 24, 48, and 72 h postexercise. At 60 min postexercise, blood flow was reduced ~29% with blockade compared with control (P < 0.05). Markers of inflammation were elevated after exercise (TNF-ɑ, IL-6), but did not differ between control and blockade. Creatine kinase concentrations peaked 12 h after exercise, and the overall response was greater with blockade (18.3 ± 3.2 kU·l-1·h-1) compared with control (11.6 ± 2.0 kU·l-1·h-1; P < 0.05). Reductions in muscle strength in control (-19.3 ± 4.3% at 24 h) were greater than blockade (-7.8 ± 4.8%; P < 0.05) and corresponded with greater perceptions of pain/discomfort in control compared with blockade. In conclusion, histamine-receptor blockade reduced postexercise blood flow, had no effect on the pattern of inflammatory markers, increased serum creatine kinase concentrations, attenuated muscle strength loss, and reduced pain perception following muscle-damaging exercise.NEW & NOTEWORTHY Histamine appears to be intimately involved with skeletal muscle during and following exercise. Blocking histamine's actions during muscle-damaging exercise, via common over-the-counter antihistamines, resulted in increased serum creatine kinase, an indirect marker of muscle damage. Paradoxically, blocking histamine's actions attenuated muscle strength loss and reduced perceptions of muscle pain for 72 h following muscle-damaging exercise. These results indicate that exercise-induced histamine release may have a broad impact on protecting muscle from exercise-induced damage.

Project description:Background There is limited information about perfusion in exercise-induced muscle injuries such as delayed-onset muscle soreness (DOMS) and the effect of compression garments as a therapeutic strategy during the regeneration phase. The purpose of this prospective, explorative study was to evaluate muscle perfusion in DOMS and to assess the effect of compression garments at resting conditions and during DOMS by magnetic resonance (MR) arterial spin labeling (ASL). Methods DOMS was induced from 03/2021 to 04/2021 using an eccentric and plyometric exercises targeting the calf muscles in 14 volunteers. A compression garment (21–22 mmHg) was worn during and for 6 h after exercise on one randomized leg. Magnetic resonance imaging (MRI) including ASL of both lower legs was performed before and directly after the exercise as well as after 6 h, and 48 h using a 3 Tesla MRI system. Perfusion analyses of the gastrocnemius muscle (GM) and the tibialis anterior muscle (TA) were performed and results were compared to baseline measurements. T2-weighted images and creatine kinase levels were acquired at baseline and after 48 h. Results All volunteers presented a successful induction of DOMS in the GM after 48 h. Arterial muscle perfusion in the GM increased from baseline to measurements taken directly after the exercise (4.97±5.59 mL/100 g/min, P<0.001). No significant alteration in perfusion compared to baseline was observed at 6 h (P=0.16) and 48 h (P=1.0) after the induction of DOMS. Compression garments did not elicit a significant alteration in ASL parameters in the GM (P=0.65) or the TA (P=0.05) at any time point. No adverse events occurred during the study. Conclusions After an initial exercise-associated increase in arterial muscle perfusion, a normalization of blood supply was observed at 6 and 48 h after the exercise intervention inducing DOMS. Wearing a compression garment (21–22 mmHg) during and after the induction of DOMS did not affect muscle perfusion at rest, nor did it have any significant effect on muscle perfusion during the regeneration phase. The results can help to better understand the pathophysiological properties of DOMS and may have implications for diagnostic and therapeutic strategies.

Dataset Information

Does Acupuncture Benefit Delayed-Onset Muscle Soreness After Strenuous Exercise? A Systematic Review and Meta-Analysis.

Publications

Does Acupuncture Benefit Delayed-Onset Muscle Soreness After Strenuous Exercise? A Systematic Review and Meta-Analysis.

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