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

Publication date: Available online 16 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Johannes Fleckenstein, Mara Friton, Heiko Himmelreich, Winfried Banzer
ObjectivesTo 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.DesignThree-arm randomized controlled study conducted in 2009.SettingDOMS was induced by eccentric exercise of the non-dominant arm in voluntary participants at the Sports Campus of a German university.InterventionsParticipants 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 measureThe 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.ResultsDOMS 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.ConclusionsA 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.



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