Effects of cryotherapy on muscle damage markers and perception of delayed onset muscle soreness after downhill running: A Pilot study

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Figura 1C: Área del CP para ojos abiertos (OA) y cerrados (OC). * Diferencia estadísticamente significativa (p < 0,05) entre grupos; # diferencia entre pruebas (OA vs. OC)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Guimaraes-Ribeiro, M. Hernández-Suárez, D. Rodríguez-Ruiz, J.M. García-Manso" "autores" => array:4 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Guimaraes-Ribeiro" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Hernández-Suárez" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Rodríguez-Ruiz" ] 3 => array:2 [ "nombre" => "J.M." 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"apellidos" => "Rossato" "email" => array:1 [ 0 => "rossato.mateus@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "E." "apellidos" => "de Souza Bezerra" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "D.A." "apellidos" => "de Ceselles Seixas da Silva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "T." "apellidos" => "Avila Santana" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "W." "apellidos" => "Rafael Malezam" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "F.P." 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There were no statistically significant differences." ] ] ] "textoCompleto" => "IntroductionThe physiological mechanism of the delayed onset muscle soreness (DOMS) after exercise is not well elucidated.<a class="elsevierStyleCrossRef" href="#bib0165">1</a> The DOMS is more frequent and of greater magnitude after exercises with a predominance of eccentric contractions.<a class="elsevierStyleCrossRef" href="#bib0165">1</a> Among the reasons for this association between DOMS and eccentric exercise is the fact that eccentric actions promote greater tension to the contractile apparatus with greater accumulation of metabolites and structural damage in tissues.<a class="elsevierStyleCrossRefs" href="#bib0165">1–3</a> The structural damage to the sarcolemma and Z lines of sarcomeres are often measured by markers such as creatine kinase (CK) and lactate dehydrogenase (LDH).<a class="elsevierStyleCrossRef" href="#bib0180">4</a>DOMS is largely observed among sportsmen, and it may have deleterious effects on human performance.<a class="elsevierStyleCrossRef" href="#bib0185">5</a> The performance degradation associated with DOMS results of mechanisms such as the loss of homeostasis of calcium (Ca2+)<a class="elsevierStyleCrossRef" href="#bib0190">6</a> and local elevation of inflammatory substances like histamine, kinins and prostaglandins.<a class="elsevierStyleCrossRef" href="#bib0195">7</a> These inflammatory substances stimulate pain receptors types III and IV.<a class="elsevierStyleCrossRefs" href="#bib0185">5,7,8</a> Thus, the effect of DOMS on performance rely on an increased sensitivity to touch changing characteristics of skin sensitivity, increased muscle stiffness and reduced range of motion.<a class="elsevierStyleCrossRefs" href="#bib0175">3,9</a>Several strategies have been used in order to speed up recovery after exercise reducing the period and magnitude of DOMS; some examples are laser therapy,<a class="elsevierStyleCrossRef" href="#bib0210">10</a> massage,<a class="elsevierStyleCrossRef" href="#bib0215">11</a> contrast (heat and cold immersion) and immersion cryotherapy;<a class="elsevierStyleCrossRef" href="#bib0220">12</a> this last one is the most popular due to the low cost and easy use by sportsmen. The vasoconstriction of blood vessels, capillaries, and lymphatics supported by cryotherapy<a class="elsevierStyleCrossRef" href="#bib0225">13</a> reduces the spread of fluid in the interstitial spaces, thereby minimizing inflammation, pain, edema, and muscular spasms.<a class="elsevierStyleCrossRefs" href="#bib0230">14–16</a>Although cryotherapy is applied to reduce the DOMS, changes in inflammatory markers show divergent outcomes.<a class="elsevierStyleCrossRefs" href="#bib0220">12,17</a> Ingram et al.,<a class="elsevierStyleCrossRef" href="#bib0220">12</a> Bailey et al., <a class="elsevierStyleCrossRef" href="#bib0245">17</a> Eston and Peters<a class="elsevierStyleCrossRef" href="#bib0235">15</a> reported no change in the concentration of CK after cryotherapy, while Rise et al. observed reduction in the concentration of CK, myoglobin and C-reactive protein after immersion in cold water. Part of the incongruence concerning these studies results from the variety of methods used, such as different water temperatures, immersion time, intensity and type of exercise performed.<a class="elsevierStyleCrossRef" href="#bib0255">19</a>The influence of cryotherapy on DOMS is evaluated in real sports context,<a class="elsevierStyleCrossRef" href="#bib0250">18</a> simulations,<a class="elsevierStyleCrossRefs" href="#bib0220">12,17,20,21</a> isokinetic dynamometry evaluations,<a class="elsevierStyleCrossRef" href="#bib0235">15</a> after a series of maximum eccentric contractions,<a class="elsevierStyleCrossRefs" href="#bib0215">11,19,22</a> vertical jumps from a higher level<a class="elsevierStyleCrossRef" href="#bib0280">24</a> and plyometrics.<a class="elsevierStyleCrossRef" href="#bib0285">25</a>Regarding the use of running protocols, Hausswirth et al.<a class="elsevierStyleCrossRef" href="#bib0260">20</a> compared the effects of the application of whole-body cryotherapy, infrared and passive recovery in a well-trained runners group on different grounds (flat, uphill and downhill). These authors concluded that whole-body cryotherapy promotes faster recovery in comparison to other methods. However, it is known that trained people in modalities that require predominant eccentric contractions are more resistant to the damage caused by these types of contractions,<a class="elsevierStyleCrossRef" href="#bib0290">26</a> which leads us to question if the application of post-eccentric exercise cryotherapy could significantly affect damage markers and pain perception in physically active people. Nevertheless, few studies<a class="elsevierStyleCrossRef" href="#bib0295">27</a> have sought a significant evaluation related to the effects of application of cryotherapy on markers of muscle damage and muscle soreness after downhill running in people considered to be physically active. As a result of the increasing number of street racing fans and the diversity of ground characteristics, studies with this perspective are necessary since the runners are exposed to situations of greater demand for eccentric contractions. Thus, the objective of this study was to investigate the effects of application of cryotherapy on markers of muscle damage, as well as the perception of muscle soreness caused predominantly by eccentric exercise after downhill running.MethodSubjectsThis study included 10 male volunteer subjects, healthy and sedentary (26±5 years of age, 173±8cm height and 70±4kg body weight). This set of subjects is similar to the ones that underwent cryotherapy in other studies (Eston and Peters<a class="elsevierStyleCrossRef" href="#bib0235">15</a>n=8, Ascensão et al.<a class="elsevierStyleCrossRef" href="#bib0250">18</a>n=10, and Santos et al.<a class="elsevierStyleCrossRef" href="#bib0300">28</a>n=9). Subjects who have participated on this study were informed about the goals and methods of the study and subsequently signed a consent form in accordance with the local ethics committee. Subjects who reported musculoskeletal problems were excluded.ProceduresThe subjects underwent two bouts of exercise with a predominance of eccentric action (PEA) with one week interval between bouts. In the end of one session, randomly, a treatment with cryotherapy was applied. The perception of pain and markers of muscle damage were measured immediately before, 24 and 48h after the PEA. The subjects were instructed to avoid intense exercise and maintain normal diet during the previous days to the testing. All tests were performed in the afternoon, with a room temperature of 24°C.The PEA was performed on a treadmill, with a negative slope of 6.6%, similar to the one used by Malm et al.<a class="elsevierStyleCrossRef" href="#bib0305">29</a> The protocol started with a five-minute warm up walk (with no slope) at 5km/h. After warming up, the treadmill was declined and subjects ran for 25min at 8km/h. After the PEA, the subjects walked for five min at 5km/h with no slope in order to calm down.The application of cryotherapy was immediately performed after the end of one of the two sessions of PEA. Cryotherapy was applied through the immersion of the lower limbs into cold water (15±1°C)<a class="elsevierStyleCrossRef" href="#bib0285">25</a> for 30min. During this period, the subjects remained standing and had both legs submerged up to the iliac crest height. A thermometer was used to check the temperature, which was regulated by the addition of ice throughout the session.The perception of DOMS was assessed by a visual analog scale of pain from 0 to 10 points,<a class="elsevierStyleCrossRef" href="#bib0250">18</a> in which zero indicates no pain and ten indicates severe pain. Initially the subjects indicated the general feeling of pain, and then reported the perception by muscle groups of the lower limbs, which are ankle dorsal and plantar flexors and knee flexors and extensors.Samples of 10ml of venous blood were collected, centrifuged and analyzed by spectrophotometry before exercise, 24 and 48h after the application of cryotherapy. Blood tests allowed the analysis of the enzymes lactate dehydrogenase (LDH) and creatine kinase (CK) using commercial kits (Labtest Diagnóstica, Lagoa Santa, MG, Brazil). These enzymes are among those indicated for monitoring muscle injuries.<a class="elsevierStyleCrossRef" href="#bib0180">4</a>Analysis of dataThe data were tested using Shapiro–Wilk for normality, followed by Mauchly's test of sphericity. In order to check the effect of cryotherapy and time after treatment, as well as their interactions, a linear mixed model of 2 factors (with and without cryotherapy; 0h, 24h or 48h) was used with Bonferroni adjustment for multiple comparisons. When there was cryotherapy effect, the comparisons were made employing Student's t test for paired samples; when there was effect on the different durations of the treatment, comparisons were made using the analysis of variance for repeated measurements – ANOVA. The significance level of 0.05 was used for all analysis using a commercial statistical package (SPSS version 13.0).ResultsThe subjects reported no DOMS before starting the PEA protocols. The culmination of the induction protocol to DOMS without the subsequent application of cryotherapy caused DOMS in 70% of the subjects. The application of cryotherapy significantly reduced (p<0.05) values of DOMS compared to the situation without cryotherapy; no differences were observed concerning the previous situation (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). In the situation without cryotherapy, DOMS increased significantly after 24 and 48h compared to the previous situation; the highest values occurred 24h after the PEA.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Reports of DOMS in different muscle groups showed a prevalence of the knee extensors of 71.4% opposite to the 57.1% of the knee flexors; and a predominance of the ankle dorsal flexors of 57.1%, opposite to the 28.5% of the ankle plantar flexors. The general DOMS reports indicated only the knee extensor muscles.Regarding markers of muscle damage, the plasma concentration of CK in both situations was higher after 24h, but it was only a significant change in the situation without cryotherapy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Plasma concentrations of LDH during the recovery period, regardless of the treatment, did not change significantly (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The concentrations of blood calcium [Ca2+] were significantly higher in the situation without cryotherapy when compared 0h and 48h (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia>DiscussionThis study has investigated the effects of cryotherapy on markers of damage and muscle soreness caused by exercise predominantly eccentric in downhill running. The results showed that the treatment with ice immediately after the PEA is able to reduce and minimize DOMS effects caused by muscle damage and that some mechanisms associated with inflammation appear to be the major determinants of DOMS in sedentary subjects.The inflammatory process caused by damage to the muscle tissue increases the concentration of pro-inflammatory chemical mediators that stimulate pain receptors.<a class="elsevierStyleCrossRefs" href="#bib0185">5,7</a> Although the mechanisms are not yet fully elucidated, it is widely accepted that cryotherapy has an analgesic effect. The ice seems to decrease the ability of sensory transmission and thus reduces acetylcholine release influencing the pain threshold.<a class="elsevierStyleCrossRef" href="#bib0255">19</a> Yet, according to these authors, another possible benefit of cryotherapy would be the change in hydrostatic pressure on the body, which could be associated with a reduction in edema and pain in the muscle.When cryotherapy is used, the values found after 24 and 48h PEA did not differ from the preconditions. This demonstrates that the application of cryotherapy maintains homeostasis in CK levels after PEA. It is speculated that cryotherapy may reduce membrane permeability and thus reduce the flow of CK into the interstitium.<a class="elsevierStyleCrossRef" href="#bib0235">15</a>However, the results found in the literature are not conclusive regarding the effects of cryotherapy on CK. The differences among the studies that concern the effectiveness of cryotherapy on DOMS depend on the type of exercise and immersion time. Ascensão et al.<a class="elsevierStyleCrossRef" href="#bib0250">18</a> observed that, after a soccer match, players treated with cryotherapy (10°C) for 10min decreased the concentrations of CK after 24 and 48h compared to the control situation (35°C). Ingram et al.<a class="elsevierStyleCrossRef" href="#bib0220">12</a> using the same temperature but with 2×5min immersions separated by 2.5min, reported no significant differences in the concentrations of CK in a group of 11 athletes. Goodall and Howatson<a class="elsevierStyleCrossRef" href="#bib0280">24</a> induce DOMS through jumps on downhill and used cryotherapy (10°C) right after the exercise, 24 and 48h later. The results indicated higher concentration of CK after intervention with cryotherapy. According to some researchers, CK shows great variability among individuals, entailing considerable heterogeneity between subjects.<a class="elsevierStyleCrossRefs" href="#bib0310">30,31</a>After PEA downhill running, LDH showed no significant changes caused by cryotherapy. Although LDH is used to assess muscle damage,<a class="elsevierStyleCrossRef" href="#bib0180">4</a> few studies have evaluated the effects of cryotherapy on its behavior. The effects of acute intervention (first hour) and subacute (24–168h) use of cryotherapy were analyzed and reported that LDH was not affected significantly by the application of cryotherapy, and that major changes were noticeable only 96h after the harmful stimulus.<a class="elsevierStyleCrossRef" href="#bib0270">22</a> Vaile et al.<a class="elsevierStyleCrossRef" href="#bib0275">23</a> who analyzed different hydrotherapy strategies for the recovery of muscle injuries, also reported no differences in the concentrations of LDH, even after 72h. In the present study the concentrations of LDH were checked 48h after the PEA, so we would expect that significant increases were not noticeable and/or cryotherapy does not cause many effects on this marker. This suggests that some blood markers can be used for evaluations of cryotherapy in acute post-exercise recovery, while others seem to be more sensitive to medium and long term changes.Cryotherapy was effective in reducing the levels of calcium ion 48h after the PEA. This can be explained by the function of cryotherapy in reducing the plasma membrane permeability.<a class="elsevierStyleCrossRef" href="#bib0235">15</a> The damage caused by PEA results in an increasing intracellular calcium concentration. It would be associated with the stimulation of the autogenic phase, increasing the action of proteases and phospholipases, with subsequent myofibrillar degradation – especially desmine and cell, thus triggering an inflammatory process.<a class="elsevierStyleCrossRef" href="#bib0185">5</a> This increased pressure also causes tissue edema, which activate pain receptors thereby increasing the feeling of discomfort associated with DOMS.<a class="elsevierStyleCrossRef" href="#bib0255">19</a> The ratio of intra- and extracellular calcium with the mechanism of skeletal muscle apoptosis can lead to reduction in muscle power, and the more releasing of inflammatory markers and DOMS, the more muscle undergoes apoptosis – thus reducing the number of myocytes chronically.<a class="elsevierStyleCrossRef" href="#bib0320">32</a>Our main conclusion is that cryotherapy after exercise is a pertinent strategy to reduce DOMS and also markers of muscle damage for street racers who perform their training on slopes. Among the limitations of this study we can mention the small number of subjects, and the fact that improvements in the perception of pain reported by the subjects after treatment cannot be compared to a placebo situation.Our results suggest that the use of cryotherapy by immersion for 30min at 15°C immediately after the practice of PEA reduces the DOMS of the lower limbs, while maintaining the homeostasis of some markers of muscle damage, such as CK and serum calcium.Conflict of interestsThe authors agree that there is no conflict of interests about this study." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres491356" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec513312" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres491357" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec513313" "titulo" => "Palabras clave" ] 4 => array:3 [ "identificador" => "xres491355" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0045" "titulo" => "Introdução" ] 1 => array:2 [ "identificador" => "abst0050" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0055" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0060" "titulo" => "Conclusão" ] ] ] 5 => array:2 [ "identificador" => "xpalclavsec513314" "titulo" => "Palavras-chave" ] 6 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 7 => array:3 [ "identificador" => "sec0010" "titulo" => "Method" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Subjects" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Procedures" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Analysis of data" ] ] ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 10 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-11-08" "fechaAceptado" => "2014-07-29" "PalabrasClave" => array:3 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec513312" "palabras" => array:4 [ 0 => "Inflammation" 1 => "Post-exercise recovery" 2 => "Fatigue" 3 => "Muscle damage" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec513313" "palabras" => array:4 [ 0 => "Inflamación" 1 => "Recuperación post-ejercicio" 2 => "Fatiga" 3 => "Daño muscular" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec513314" "palabras" => array:4 [ 0 => "Inflamação" 1 => "Recuperação pós-exercício" 2 => "Fadiga" 3 => "Dano muscular" ] ] ] ] "tieneResumen" => true "resumen" => array:3 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveTo investigate the effects of cryotherapy on markers of muscle damage, as well as the perception of muscle soreness caused by eccentric exercise after downhill running. MethodsTen participants (age=26±5year, height=173±8cm and body mass=70±4kg) performed two running trials on a treadmill tilted –6.6%, separated by one-week period. Cryotherapy (∼15°C for 30 minutes) was conducted after one of the trials of exercise. Blood samples were analyzed for markers of muscle damage (creatine kinase – CK; lactate dehydrogenase – LDH; calcium – [Ca2+]). Perception of muscle soreness was quantified using an analogical scale of pain. Data were collected before, 24 and 48h after the trials with and without the use of cryotherapy. ResultsCryotherapy significantly reduced muscle soreness and was able to reestablish homeostasis in CK, LDH and [Ca2+]. ConclusionUse of cryotherapy after exercise with eccentric contractions was effective to reestablish the level of biochemical markers of muscle damage and reduce muscle soreness and pain perception in subjects submitted to downhill running." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoInvestigar los efectos de la crioterapia en los marcadores de daño muscular, así como la percepción de mialgia causada por ejercicio excéntrico tras carrera en bajada. MétodoDiez participantes (edad=26,0±5,0 años, altura=173,0±8,0cm y masa corporal=70,5±4,0kg) realizaron dos ensayos de carrera en tapiz rodante con una inclinación de –6.6%, separados por un periodo de una semana. Se llevó a cabo una sesión de crioterapia (∼15°C,) tras cada uno de los ensayos. Se analizaron muestras de sangre para determinar los marcadores de daño muscular (creatín kinasa–CK; deshidrogenasa láctica–DHL; calcio - [Ca2+]). La percepción de dolor muscular fue cuantificada usando una escala analógica de dolor. Los datos se tomaron antes, 24h y 48h después de los ensayos con y sin el uso de crioterapia. ResultadosLa crioterapia disminuyó significantemente el dolor muscular y fue capaz de reestablecer la homeostasis en CK, DHL y [Ca2+]. Conclusión: El uso de crioterapia tras ejercicio con contracciones excéntricas fue efectivo para reestablecer el nivel de los marcadores bioquímicos de daño muscular y reducir la mialgia y la percepción de dolor en sujetos sometidos a carrera en bajada." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "IntroduçãoO dano muscular é frequentemente observado em indivíduos envolvidos em atividades físicas que envolvam contrações excêntricas. Nestas situações, a crioterapia é utilizada para reduzir o dano muscular e a sensação de dor. No entanto, poucos estudos investigaram o efeito da imersão em agua gelada em marcadores de dano muscular, bem como a percepção de dor após exercício excêntrico. MétodoDez homens (26,0±5,0 anos de idade, 173,0±8,0cm de estatura, 70,5±4,0kg de massa corporal). Os voluntários completaram dois corridas (teste e controle) separadas por sete dias, em um percurso declinado (–6,6%) em esteira. Em uma das tentativas realizou-se imersão em água gelada (∼15°C, 30 minutos). O dano muscular foi estimado mediante os níveis sanguíneos de (creatina quinase–CK; lactato desidrogenase–LDH e cálcio–[Ca2+]). A percepção de dor muscular foi estimada usando uma escala analógica. Todas as medidas foram realizadas antes, 24 e 48 horas pós-exercício. ResultadosA imersão em agua gelada diminuiu significativamente a dor muscular e auxiliou no reestabelecimento da homeostase da CH, LDH e Ca2+. ConclusãoA imersão em agua gelada após exercício excêntrico foi efetiva em reestabelecer os níveis bioquímicos de marcadores musculares e diminuiu a percepcao de dor." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0045" "titulo" => "Introdução" ] 1 => array:2 [ "identificador" => "abst0050" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0055" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0060" "titulo" => "Conclusão" ] ] ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1452 "Ancho" => 1537 "Tamanyo" => 61597 ] ] "descripcion" => array:1 [ "en" => "Concentration of the creatine kinase (CK) in the pre-PEA (preconditions to the exercise with predominance of eccentric action, 0h), 24h and 48h after PEA conditions. * Indicates significant differences (p<0.05) for pre-PEA (0h) and 48h." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1617 "Ancho" => 1550 "Tamanyo" => 76929 ] ] "descripcion" => array:1 [ "en" => "Concentration of the lactate dehydrogenase (LDH) in the pre-PEA (preconditions to the exercise with predominance of eccentric action, 0h), 24 and 48h after exercise. There were no statistically significant differences." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1645 "Ancho" => 1558 "Tamanyo" => 64370 ] ] "descripcion" => array:1 [ "en" => "Concentration of calcium [Ca2+] in the pre-PEA (preconditions to the exercise with predominance of eccentric action, 0h), 24h and 48h after exercise. * Indicates significant differences (p<0.05) compared to pre-PEA (0h)." ] ] 3 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Without cryotherapy</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">With cryotherapy</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pre \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">24h \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">48h \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pre \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">24h \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">48h \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Pain scale \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.2±2.4<a class="elsevierStyleCrossRefs" href="#tblfn0005">*,#</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.3±2.6<a class="elsevierStyleCrossRefs" href="#tblfn0005">*,#</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab781202.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "Statistically significant difference (p<0.05) compared to the group with cryotherapy." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "#" "nota" => "Statistically significant difference (p<0.05) compared to Pre." ] ] ] "descripcion" => array:1 [ "en" => "Scores for pain scale, expressed as mean±standard deviation for the group of subjects in the conditions with and without the application of cryotherapy." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0165" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eccentric muscle actions: implications for injury prevention and rehabilitation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.R. 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Efectos de la crioterapia en los marcadores de daño muscular y en la percepción de mialgia de aparición tardía tras carrera en bajada

Efeito da imersão em agua gelada no dano muscular e dor tardia após a corrida de downhill: um estudo piloto

M. Rossatoa,

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rossato.mateus@gmail.com

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, E. de Souza Bezerraa, D.A. de Ceselles Seixas da Silvaa, T. Avila Santanab, W. Rafael Malezamc, F.P. Carpesd

a Federal University of Amazonas, Manaus, Brazil

b University Center North, Manaus, Brazil

c Federal University of São Paulo, São Paulo, Brazil

d Laboratory of Neuromechanics, Federal University of Pampa, Uruguaiana, Brazil

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    "titulo" => "Effects of cryotherapy on muscle damage markers and perception of delayed onset muscle soreness after downhill running&#58; A Pilot study"
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Concentration of the lactate dehydrogenase &#40;LDH&#41; in the pre-PEA &#40;preconditions to the exercise with predominance of eccentric action&#44; 0<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; 24 and 48<span class="elsevierStyleHsp" style=""></span>h after exercise&#46; There were no statistically significant differences&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The physiological mechanism of the delayed onset muscle soreness &#40;DOMS&#41; after exercise is not well elucidated&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">1</span></a> The DOMS is more frequent and of greater magnitude after exercises with a predominance of eccentric contractions&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">1</span></a> Among the reasons for this association between DOMS and eccentric exercise is the fact that eccentric actions promote greater tension to the contractile apparatus with greater accumulation of metabolites and structural damage in tissues&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1&#8211;3</span></a> The structural damage to the sarcolemma and Z lines of sarcomeres are often measured by markers such as creatine kinase &#40;CK&#41; and lactate dehydrogenase &#40;LDH&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">DOMS is largely observed among sportsmen&#44; and it may have deleterious effects on human performance&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">5</span></a> The performance degradation associated with DOMS results of mechanisms such as the loss of homeostasis of calcium &#40;Ca<span class="elsevierStyleSup">2&#43;</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">6</span></a> and local elevation of inflammatory substances like histamine&#44; kinins and prostaglandins&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">7</span></a> These inflammatory substances stimulate pain receptors types III and IV&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">5&#44;7&#44;8</span></a> Thus&#44; the effect of DOMS on performance rely on an increased sensitivity to touch changing characteristics of skin sensitivity&#44; increased muscle stiffness and reduced range of motion&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">3&#44;9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Several strategies have been used in order to speed up recovery after exercise reducing the period and magnitude of DOMS&#59; some examples are laser therapy&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">10</span></a> massage&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">11</span></a> contrast &#40;heat and cold immersion&#41; and immersion cryotherapy&#59;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a> this last one is the most popular due to the low cost and easy use by sportsmen&#46; The vasoconstriction of blood vessels&#44; capillaries&#44; and lymphatics supported by cryotherapy<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a> reduces the spread of fluid in the interstitial spaces&#44; thereby minimizing inflammation&#44; pain&#44; edema&#44; and muscular spasms&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">14&#8211;16</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Although cryotherapy is applied to reduce the DOMS&#44; changes in inflammatory markers show divergent outcomes&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">12&#44;17</span></a> Ingram et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a> Bailey et al&#46;&#44; <a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">17</span></a> Eston and Peters<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a> reported no change in the concentration of CK after cryotherapy&#44; while Rise et al&#46; observed reduction in the concentration of CK&#44; myoglobin and C-reactive protein after immersion in cold water&#46; Part of the incongruence concerning these studies results from the variety of methods used&#44; such as different water temperatures&#44; immersion time&#44; intensity and type of exercise performed&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The influence of cryotherapy on DOMS is evaluated in real sports context&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a> simulations&#44;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">12&#44;17&#44;20&#44;21</span></a> isokinetic dynamometry evaluations&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a> after a series of maximum eccentric contractions&#44;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">11&#44;19&#44;22</span></a> vertical jumps from a higher level<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">24</span></a> and plyometrics&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">25</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Regarding the use of running protocols&#44; Hausswirth et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">20</span></a> compared the effects of the application of whole-body cryotherapy&#44; infrared and passive recovery in a well-trained runners group on different grounds &#40;flat&#44; uphill and downhill&#41;&#46; These authors concluded that whole-body cryotherapy promotes faster recovery in comparison to other methods&#46; However&#44; it is known that trained people in modalities that require predominant eccentric contractions are more resistant to the damage caused by these types of contractions&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">26</span></a> which leads us to question if the application of post-eccentric exercise cryotherapy could significantly affect damage markers and pain perception in physically active people&#46; Nevertheless&#44; few studies<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">27</span></a> have sought a significant evaluation related to the effects of application of cryotherapy on markers of muscle damage and muscle soreness after downhill running in people considered to be physically active&#46; As a result of the increasing number of street racing fans and the diversity of ground characteristics&#44; studies with this perspective are necessary since the runners are exposed to situations of greater demand for eccentric contractions&#46; Thus&#44; the objective of this study was to investigate the effects of application of cryotherapy on markers of muscle damage&#44; as well as the perception of muscle soreness caused predominantly by eccentric exercise after downhill running&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Method</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Subjects</span><p id="par0035" class="elsevierStylePara elsevierViewall">This study included 10 male volunteer subjects&#44; healthy and sedentary &#40;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5 years of age&#44; 173<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>cm height and 70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>kg body weight&#41;&#46; This set of subjects is similar to the ones that underwent cryotherapy in other studies &#40;Eston and Peters<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#44; Ascens&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#44; and Santos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#41;&#46; Subjects who have participated on this study were informed about the goals and methods of the study and subsequently signed a consent form in accordance with the local ethics committee&#46; Subjects who reported musculoskeletal problems were excluded&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Procedures</span><p id="par0040" class="elsevierStylePara elsevierViewall">The subjects underwent two bouts of exercise with a predominance of eccentric action &#40;PEA&#41; with one week interval between bouts&#46; In the end of one session&#44; randomly&#44; a treatment with cryotherapy was applied&#46; The perception of pain and markers of muscle damage were measured immediately before&#44; 24 and 48<span class="elsevierStyleHsp" style=""></span>h after the PEA&#46; The subjects were instructed to avoid intense exercise and maintain normal diet during the previous days to the testing&#46; All tests were performed in the afternoon&#44; with a room temperature of 24<span class="elsevierStyleHsp" style=""></span>&#176;C&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The PEA was performed on a treadmill&#44; with a negative slope of 6&#46;6&#37;&#44; similar to the one used by Malm et al&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">29</span></a> The protocol started with a five-minute warm up walk &#40;with no slope&#41; at 5<span class="elsevierStyleHsp" style=""></span>km&#47;h&#46; After warming up&#44; the treadmill was declined and subjects ran for 25<span class="elsevierStyleHsp" style=""></span>min at 8<span class="elsevierStyleHsp" style=""></span>km&#47;h&#46; After the PEA&#44; the subjects walked for five min at 5<span class="elsevierStyleHsp" style=""></span>km&#47;h with no slope in order to calm down&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The application of cryotherapy was immediately performed after the end of one of the two sessions of PEA&#46; Cryotherapy was applied through the immersion of the lower limbs into cold water &#40;15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>&#176;C&#41;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">25</span></a> for 30<span class="elsevierStyleHsp" style=""></span>min&#46; During this period&#44; the subjects remained standing and had both legs submerged up to the iliac crest height&#46; A thermometer was used to check the temperature&#44; which was regulated by the addition of ice throughout the session&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The perception of DOMS was assessed by a visual analog scale of pain from 0 to 10 points&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a> in which zero indicates no pain and ten indicates severe pain&#46; Initially the subjects indicated the general feeling of pain&#44; and then reported the perception by muscle groups of the lower limbs&#44; which are ankle dorsal and plantar flexors and knee flexors and extensors&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Samples of 10<span class="elsevierStyleHsp" style=""></span>ml of venous blood were collected&#44; centrifuged and analyzed by spectrophotometry before exercise&#44; 24 and 48<span class="elsevierStyleHsp" style=""></span>h after the application of cryotherapy&#46; Blood tests allowed the analysis of the enzymes lactate dehydrogenase &#40;LDH&#41; and creatine kinase &#40;CK&#41; using commercial kits &#40;Labtest Diagn&#243;stica&#44; Lagoa Santa&#44; MG&#44; Brazil&#41;&#46; These enzymes are among those indicated for monitoring muscle injuries&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">4</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Analysis of data</span><p id="par0065" class="elsevierStylePara elsevierViewall">The data were tested using Shapiro&#8211;Wilk for normality&#44; followed by Mauchly&#39;s test of sphericity&#46; In order to check the effect of cryotherapy and time after treatment&#44; as well as their interactions&#44; a linear mixed model of 2 factors &#40;with and without cryotherapy&#59; 0<span class="elsevierStyleHsp" style=""></span>h&#44; 24<span class="elsevierStyleHsp" style=""></span>h or 48<span class="elsevierStyleHsp" style=""></span>h&#41; was used with Bonferroni adjustment for multiple comparisons&#46; When there was cryotherapy effect&#44; the comparisons were made employing Student&#39;s <span class="elsevierStyleItalic">t</span> test for paired samples&#59; when there was effect on the different durations of the treatment&#44; comparisons were made using the analysis of variance for repeated measurements &#8211; ANOVA&#46; The significance level of 0&#46;05 was used for all analysis using a commercial statistical package &#40;SPSS version 13&#46;0&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Results</span><p id="par0070" class="elsevierStylePara elsevierViewall">The subjects reported no DOMS before starting the PEA protocols&#46; The culmination of the induction protocol to DOMS without the subsequent application of cryotherapy caused DOMS in 70&#37; of the subjects&#46; The application of cryotherapy significantly reduced &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; values of DOMS compared to the situation without cryotherapy&#59; no differences were observed concerning the previous situation &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; In the situation without cryotherapy&#44; DOMS increased significantly after 24 and 48<span class="elsevierStyleHsp" style=""></span>h compared to the previous situation&#59; the highest values occurred 24<span class="elsevierStyleHsp" style=""></span>h after the PEA&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Reports of DOMS in different muscle groups showed a prevalence of the knee extensors of 71&#46;4&#37; opposite to the 57&#46;1&#37; of the knee flexors&#59; and a predominance of the ankle dorsal flexors of 57&#46;1&#37;&#44; opposite to the 28&#46;5&#37; of the ankle plantar flexors&#46; The general DOMS reports indicated only the knee extensor muscles&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Regarding markers of muscle damage&#44; the plasma concentration of CK in both situations was higher after 24<span class="elsevierStyleHsp" style=""></span>h&#44; but it was only a significant change in the situation without cryotherapy &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Plasma concentrations of LDH during the recovery period&#44; regardless of the treatment&#44; did not change significantly &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The concentrations of blood calcium &#91;Ca<span class="elsevierStyleSup">2&#43;</span>&#93; were significantly higher in the situation without cryotherapy when compared 0<span class="elsevierStyleHsp" style=""></span>h and 48<span class="elsevierStyleHsp" style=""></span>h &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study has investigated the effects of cryotherapy on markers of damage and muscle soreness caused by exercise predominantly eccentric in downhill running&#46; The results showed that the treatment with ice immediately after the PEA is able to reduce and minimize DOMS effects caused by muscle damage and that some mechanisms associated with inflammation appear to be the major determinants of DOMS in sedentary subjects&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The inflammatory process caused by damage to the muscle tissue increases the concentration of pro-inflammatory chemical mediators that stimulate pain receptors&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">5&#44;7</span></a> Although the mechanisms are not yet fully elucidated&#44; it is widely accepted that cryotherapy has an analgesic effect&#46; The ice seems to decrease the ability of sensory transmission and thus reduces acetylcholine release influencing the pain threshold&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> Yet&#44; according to these authors&#44; another possible benefit of cryotherapy would be the change in hydrostatic pressure on the body&#44; which could be associated with a reduction in edema and pain in the muscle&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">When cryotherapy is used&#44; the values found after 24 and 48<span class="elsevierStyleHsp" style=""></span>h PEA did not differ from the preconditions&#46; This demonstrates that the application of cryotherapy maintains homeostasis in CK levels after PEA&#46; It is speculated that cryotherapy may reduce membrane permeability and thus reduce the flow of CK into the interstitium&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">However&#44; the results found in the literature are not conclusive regarding the effects of cryotherapy on CK&#46; The differences among the studies that concern the effectiveness of cryotherapy on DOMS depend on the type of exercise and immersion time&#46; Ascens&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a> observed that&#44; after a soccer match&#44; players treated with cryotherapy &#40;10<span class="elsevierStyleHsp" style=""></span>&#176;C&#41; for 10<span class="elsevierStyleHsp" style=""></span>min decreased the concentrations of CK after 24 and 48<span class="elsevierStyleHsp" style=""></span>h compared to the control situation &#40;35<span class="elsevierStyleHsp" style=""></span>&#176;C&#41;&#46; Ingram et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a> using the same temperature but with 2<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>min immersions separated by 2&#46;5<span class="elsevierStyleHsp" style=""></span>min&#44; reported no significant differences in the concentrations of CK in a group of 11 athletes&#46; Goodall and Howatson<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">24</span></a> induce DOMS through jumps on downhill and used cryotherapy &#40;10<span class="elsevierStyleHsp" style=""></span>&#176;C&#41; right after the exercise&#44; 24 and 48<span class="elsevierStyleHsp" style=""></span>h later&#46; The results indicated higher concentration of CK after intervention with cryotherapy&#46; According to some researchers&#44; CK shows great variability among individuals&#44; entailing considerable heterogeneity between subjects&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">30&#44;31</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">After PEA downhill running&#44; LDH showed no significant changes caused by cryotherapy&#46; Although LDH is used to assess muscle damage&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">4</span></a> few studies have evaluated the effects of cryotherapy on its behavior&#46; The effects of acute intervention &#40;first hour&#41; and subacute &#40;24&#8211;168<span class="elsevierStyleHsp" style=""></span>h&#41; use of cryotherapy were analyzed and reported that LDH was not affected significantly by the application of cryotherapy&#44; and that major changes were noticeable only 96<span class="elsevierStyleHsp" style=""></span>h after the harmful stimulus&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">22</span></a> Vaile et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">23</span></a> who analyzed different hydrotherapy strategies for the recovery of muscle injuries&#44; also reported no differences in the concentrations of LDH&#44; even after 72<span class="elsevierStyleHsp" style=""></span>h&#46; In the present study the concentrations of LDH were checked 48<span class="elsevierStyleHsp" style=""></span>h after the PEA&#44; so we would expect that significant increases were not noticeable and&#47;or cryotherapy does not cause many effects on this marker&#46; This suggests that some blood markers can be used for evaluations of cryotherapy in acute post-exercise recovery&#44; while others seem to be more sensitive to medium and long term changes&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Cryotherapy was effective in reducing the levels of calcium ion 48<span class="elsevierStyleHsp" style=""></span>h after the PEA&#46; This can be explained by the function of cryotherapy in reducing the plasma membrane permeability&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a> The damage caused by PEA results in an increasing intracellular calcium concentration&#46; It would be associated with the stimulation of the autogenic phase&#44; increasing the action of proteases and phospholipases&#44; with subsequent myofibrillar degradation &#8211; especially desmine and cell&#44; thus triggering an inflammatory process&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">5</span></a> This increased pressure also causes tissue edema&#44; which activate pain receptors thereby increasing the feeling of discomfort associated with DOMS&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> The ratio of intra- and extracellular calcium with the mechanism of skeletal muscle apoptosis can lead to reduction in muscle power&#44; and the more releasing of inflammatory markers and DOMS&#44; the more muscle undergoes apoptosis &#8211; thus reducing the number of myocytes chronically&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Our main conclusion is that cryotherapy after exercise is a pertinent strategy to reduce DOMS and also markers of muscle damage for street racers who perform their training on slopes&#46; Among the limitations of this study we can mention the small number of subjects&#44; and the fact that improvements in the perception of pain reported by the subjects after treatment cannot be compared to a placebo situation&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Our results suggest that the use of cryotherapy by immersion for 30<span class="elsevierStyleHsp" style=""></span>min at 15<span class="elsevierStyleHsp" style=""></span>&#176;C immediately after the practice of PEA reduces the DOMS of the lower limbs&#44; while maintaining the homeostasis of some markers of muscle damage&#44; such as CK and serum calcium&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of interests</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors agree that there is no conflict of interests about this study&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To investigate the effects of cryotherapy on markers of muscle damage&#44; as well as the perception of muscle soreness caused by eccentric exercise after downhill running&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ten participants &#40;age<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>year&#44; height<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>173<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>cm and body mass<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>kg&#41; performed two running trials on a treadmill tilted &#8211;6&#46;6&#37;&#44; separated by one-week period&#46; Cryotherapy &#40;&#8764;15<span class="elsevierStyleHsp" style=""></span>&#176;C for 30 minutes&#41; was conducted after one of the trials of exercise&#46; Blood samples were analyzed for markers of muscle damage &#40;creatine kinase &#8211; CK&#59; lactate dehydrogenase &#8211; LDH&#59; calcium &#8211; &#91;Ca<span class="elsevierStyleSup">2&#43;</span>&#93;&#41;&#46; Perception of muscle soreness was quantified using an analogical scale of pain&#46; Data were collected before&#44; 24 and 48<span class="elsevierStyleHsp" style=""></span>h after the trials with and without the use of cryotherapy&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cryotherapy significantly reduced muscle soreness and was able to reestablish homeostasis in CK&#44; LDH and &#91;Ca<span class="elsevierStyleSup">2&#43;</span>&#93;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Use of cryotherapy after exercise with eccentric contractions was effective to reestablish the level of biochemical markers of muscle damage and reduce muscle soreness and pain perception in subjects submitted to downhill running&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Investigar los efectos de la crioterapia en los marcadores de da&#241;o muscular&#44; as&#237; como la percepci&#243;n de mialgia causada por ejercicio exc&#233;ntrico tras carrera en bajada&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Diez participantes &#40;edad<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;0 a&#241;os&#44; altura<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>173&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;0<span class="elsevierStyleHsp" style=""></span>cm y masa corporal<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>70&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;0<span class="elsevierStyleHsp" style=""></span>kg&#41; realizaron dos ensayos de carrera en tapiz rodante con una inclinaci&#243;n de &#8211;6&#46;6&#37;&#44; separados por un periodo de una semana&#46; Se llev&#243; a cabo una sesi&#243;n de crioterapia &#40;&#8764;15<span class="elsevierStyleHsp" style=""></span>&#176;C&#44;&#41; tras cada uno de los ensayos&#46; Se analizaron muestras de sangre para determinar los marcadores de da&#241;o muscular &#40;creat&#237;n kinasa&#8211;CK&#59; deshidrogenasa l&#225;ctica&#8211;DHL&#59; calcio - &#91;Ca2&#43;&#93;&#41;&#46; La percepci&#243;n de dolor muscular fue cuantificada usando una escala anal&#243;gica de dolor&#46; Los datos se tomaron antes&#44; 24<span class="elsevierStyleHsp" style=""></span>h y 48<span class="elsevierStyleHsp" style=""></span>h despu&#233;s de los ensayos con y sin el uso de crioterapia&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La crioterapia disminuy&#243; significantemente el dolor muscular y fue capaz de reestablecer la homeostasis en CK&#44; DHL y &#91;Ca2&#43;&#93;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">&#58; El uso de crioterapia tras ejercicio con contracciones exc&#233;ntricas fue efectivo para reestablecer el nivel de los marcadores bioqu&#237;micos de da&#241;o muscular y reducir la mialgia y la percepci&#243;n de dolor en sujetos sometidos a carrera en bajada&#46;</p></span>"
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        "resumen" => "<span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Introdu&#231;&#227;o</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">O dano muscular &#233; frequentemente observado em indiv&#237;duos envolvidos em atividades f&#237;sicas que envolvam contra&#231;&#245;es exc&#234;ntricas&#46; Nestas situa&#231;&#245;es&#44; a crioterapia &#233; utilizada para reduzir o dano muscular e a sensa&#231;&#227;o de dor&#46; No entanto&#44; poucos estudos investigaram o efeito da imers&#227;o em agua gelada em marcadores de dano muscular&#44; bem como a percep&#231;&#227;o de dor ap&#243;s exerc&#237;cio exc&#234;ntrico&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">M&#233;todo</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Dez homens &#40;26&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;0 anos de idade&#44; 173&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;0<span class="elsevierStyleHsp" style=""></span>cm de estatura&#44; 70&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;0<span class="elsevierStyleHsp" style=""></span>kg de massa corporal&#41;&#46; Os volunt&#225;rios completaram dois corridas &#40;teste e controle&#41; separadas por sete dias&#44; em um percurso declinado &#40;&#8211;6&#44;6&#37;&#41; em esteira&#46; Em uma das tentativas realizou-se imers&#227;o em &#225;gua gelada &#40;&#8764;15<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; 30 minutos&#41;&#46; O dano muscular foi estimado mediante os n&#237;veis sangu&#237;neos de &#40;creatina quinase&#8211;CK&#59; lactato desidrogenase&#8211;LDH e c&#225;lcio&#8211;&#91;Ca2&#43;&#93;&#41;&#46; A percep&#231;&#227;o de dor muscular foi estimada usando uma escala anal&#243;gica&#46; Todas as medidas foram realizadas antes&#44; 24 e 48 horas p&#243;s-exerc&#237;cio&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Resultados</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">A imers&#227;o em agua gelada diminuiu significativamente a dor muscular e auxiliou no reestabelecimento da homeostase da CH&#44; LDH e Ca2&#43;&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclus&#227;o</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">A imers&#227;o em agua gelada ap&#243;s exerc&#237;cio exc&#234;ntrico foi efetiva em reestabelecer os n&#237;veis bioqu&#237;micos de marcadores musculares e diminuiu a percepcao de dor&#46;</p></span>"
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Article information

ISSN: 18887546
Original language: English

DOI:10.1016/j.ramd.2014.07.003

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Year/Month	Html	Pdf	Total

2024 November	10	1	11
2024 October	35	12	47
2024 September	74	7	81
2024 August	63	6	69
2024 July	49	9	58
2024 June	26	2	28
2024 May	42	4	46
2024 April	32	11	43
2024 March	48	3	51
2024 February	48	6	54
2024 January	88	8	96
2023 December	43	14	57
2023 November	30	2	32
2023 October	32	4	36
2023 September	14	4	18
2023 August	28	4	32
2023 July	21	7	28
2023 June	21	0	21
2023 May	47	4	51
2023 April	67	8	75
2023 March	26	5	31
2023 February	29	2	31
2023 January	35	2	37
2022 December	19	3	22
2022 November	29	3	32
2022 October	22	7	29
2022 September	22	13	35
2022 August	31	4	35
2022 July	30	7	37
2022 June	25	3	28
2022 May	20	6	26
2022 April	36	12	48
2022 March	34	8	42
2022 February	63	4	67
2022 January	55	11	66
2021 December	37	12	49
2021 November	37	6	43
2021 October	54	19	73
2021 September	24	15	39
2021 August	23	8	31
2021 July	51	8	59
2021 June	25	8	33
2021 May	33	8	41
2021 April	128	11	139
2021 March	56	6	62
2021 February	48	4	52
2021 January	35	14	49
2020 December	48	9	57
2020 November	40	9	49
2020 October	34	6	40
2020 September	33	12	45
2020 August	35	12	47
2020 July	12	11	23
2020 June	29	13	42
2020 May	31	11	42
2020 April	49	11	60
2020 March	49	12	61
2020 February	58	13	71
2020 January	37	7	44
2019 December	73	23	96
2019 November	56	14	70
2019 October	63	9	72
2019 September	55	7	62
2019 August	50	6	56
2019 July	74	11	85
2019 June	77	14	91
2019 May	221	45	266
2019 April	95	12	107
2019 March	36	14	50
2019 February	23	9	32
2019 January	26	11	37
2018 December	20	11	31
2018 November	31	14	45
2018 October	51	26	77
2018 September	23	4	27
2018 August	14	0	14
2018 July	13	5	18
2018 June	18	0	18
2018 May	35	4	39
2018 April	27	8	35
2018 March	17	2	19
2018 February	24	2	26
2018 January	19	1	20
2017 December	23	1	24
2017 November	21	1	22
2017 October	34	5	39
2017 September	16	4	20
2017 August	35	4	39
2017 July	28	4	32
2017 June	39	22	61
2017 May	46	11	57
2017 April	42	30	72
2017 March	41	60	101
2017 February	34	7	41
2017 January	30	4	34
2016 December	47	8	55
2016 November	58	2	60
2016 October	77	7	84
2016 September	58	13	71
2016 August	24	5	29
2016 July	41	5	46
2016 June	81	1	82
2016 May	47	2	49
2016 April	48	1	49
2016 March	46	30	76
2016 February	49	28	77
2016 January	41	34	75
2015 December	40	24	64
2015 November	60	32	92
2015 October	89	48	137
2015 September	48	17	65
2015 August	114	22	136
2015 July	127	34	161
2015 June	204	59	263
2015 May	125	40	165

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