Massage and Cold Water Immersion on Movement Variability After Fatigue in Swimmers

Effects of Post Exercise Massage and Cold-water Immersion on Movement Variability After Fatigue in Swimmers: a Randomized Controlled Clinical Trial

The goal of this clinical trial is to investigate the effectiveness of post-exercise massage and cold-water immersion compared to control in young elite swimmers. The main questions it aims to answer are:

• Is post-exercise techniques effective for recovery of the movement variability, , myotonometric, ergometric and perceptive parameters after fatigue?
• Can neuromuscular fatigue protocols impair movement variability, myotonometric, ergometric and perceptive parameters?
• What tests are reliable to assess different aspects of swimmers' recovery?

Researchers will compare massage and cold-water immersion to control and to each other to see if recovery is antecipated. They will also compare an in-water and an out-of-water fatigue protocol to see if they are effective and can be used in different settings.

Participants will:

• Perform test and retest sessions to assess movement variability, myotonometric, ergometric and perceptive parameters.
• Perform an in-water fatigue protocol consisting of 8x100m front-crawl sprints
• Receive three recovery strategies in a randomized order (massage, cold-water immersion and control (i.e. rest)
• Answer a questionnaire regarding ther beliefs and preferences for recovery.

Study Overview

• Status: Completed
• Conditions: Movement Disorders; Muscle Tone; Perceived Exertion
• Intervention / Treatment: Other: Massage; Other: Cold water immersion

Detailed Description

Fifty swimmers from São Paulo state swimming teams will be initially assessed to investigate movement patterns at rest and after a fatigue protocol by means of inertial sensors. The participants will be assessed regarding their perceptions by the Swimmer's Perception of Effort Questionnaire (SPEQ), muscle stiffness by a myotonometer, skin temperature by a thermographic infrared camera and coordination by the Coordination Index and Continuous Relative Phase (CRP). Then, the athletes will perform the fatigue protocol again followed by five interventions in a crossover design separated by 24hr: i) superficial massage, ii) deep massage iii) cold-water immersion iv) immersion in thermoneutral water and v) control (no intervention). All procedures will be performed for an experimental task of shoulder elevation and the sport-specific gesture (front crawl simulation in swim bench). The statistical analysis will be conducted in SPSS software. To analyze fractal properties of time series the detrended fluctuation analysis (DFA) will be used where (α) varies from 0,5 to 1,5, interpreted as random series and Brownian noise, respectively. To compared pre and post assessments from initial testing the paired t test will be used. To compare perceptions, muscle stiffness and temperature between groups after fatigue protocol and intervention a Mixed ANOVA will be used with Greenhouse-Geisser corrections and Bonferroni post-hoc if necessary. Descriptive data will be presented as mean and standard deviations. All analysis will assume level of significance of P< 0,05.

• Study Type: Interventional
• Enrollment (Actual): 22
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Brazil
  • São Paulo
    • Presidente Prudente, São Paulo, Brazil, 19060-900
      • Faculty of Science and Technology (UNESP)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 20 years (Child, Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• male and female athletes
• between 15 and 30 years old
• no injury over the last month (any complaint that prevented the athlete from training or compete at least once)

Exclusion Criteria:

• use of pain killers at least 24h before study participation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Massage; 12 minutes of effleurage and petrissage on the upper limbs administered after fatiguing exercise in the swimming pool	Other: Massage; 12 minutes of effleurage and petrissage on the upper limbs
Experimental: Cold-water immersion; 12 minutes of cold-water immersion at the shoulder level with water temperature between 11 to 15°C	Other: Cold water immersion; 12 minutes of cold water immersion at the shoulder level with water temperature between 11 to 15°C
No Intervention: Control; 12 minutes of rest. The athletes are free to sit or walk around the place but are advised to refrain from exercise in and out of the pool.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Movement variability	Obtained from time series of biomechanical data expressed as degrees of shoulder and elbow flexion, and ergometric variables (i.e. pace, stroke frequency and average power) executed during a simulated out of water swim ergometric test to understand the impacts of fatigue on movement and explore changes during recovery. Measured at baseline, post-fatigue and post-interventions. Joint angles time series of shoulder and elbow flexion and ergometric variables were aggregated using mean, standard deviation and variation coefficients for data analyses.	From enrollment to the end of crossover treatments at 6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Swim-related perceptions	Self-reported ratings regarding physical and mental readiness for exercise, fatigue, vigor, somnolence, pain, and perception of effort and recovery, measured by a numerical rating scale ranging from 0 (nothing) to 10 (extreme). Measured at baseline, post-fatigue and post-interventions	From enrollment to the end of crossover treatments at 6 weeks
Myotonometry	Muscle tone, stiffness and elasticity were assessed by the MyotonPRO. The equipment probe will be placed perpendicular to the skin surface on the muscle belly previously marked with a pen by the evaluator at 1: Deltoid; 2: Pectoralis Major; 3: Biceps brachii; 4: Upper Trapezius; 5: Latissimus dorsi; 7: Triceps. Values were deemed acceptable if there were less than 3% of variation between the impulses. Measured at baseline, post-fatigue and post-interventions.	From enrollment to the end of crossover treatments at 6 weeks
Skin temperature	The temperature will be measured using an infrared thermographic camera, at the same points of myotonometry. Measured before and after the interventions.	From week 4 to 6
Beliefs in the recovery techniques	Participants will be asked if they believe that massage, cold-water immersion and resting contribute to their recovery before and after the study	Week 6
Preference	After the study the participants will be asked which of the interventions they preferred to received to recover from the fatiguing exercise	Week 6
Sense of position	Participants will be asked to position their dominant upper limb at 90° which will be indicated by a target fixed on the wall 1 meter ahead of them. They will have 3 chances to point at the target and memorize the position. Afterwards, participants will have 3 chances to point at the target without vision (by blindfold). Measured at baseline, post-fatigue and post-interventions	From enrollment to the end of crossover treatments at 6 weeks

Collaborators and Investigators

• Sponsor: Flávia Carvalho
• Collaborators: São Paulo State University; Universidade Estadual Paulista Júlio de Mesquita Filho
• Investigators: Study Director: Carlos M Pastre, Doctor, University of São Paulo State, UNESP

Study record dates

Study Major Dates

• Study Start (Actual): March 6, 2023
• Primary Completion (Actual): September 30, 2023
• Study Completion (Actual): September 30, 2023

Study Registration Dates

• First Submitted: August 27, 2020
• First Submitted That Met QC Criteria: September 1, 2020
• First Posted (Actual): September 9, 2020

Study Record Updates

• Last Update Posted (Estimated): November 5, 2024
• Last Update Submitted That Met QC Criteria: November 4, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: Massage; Cryotherapy; Swimming; movement variability
• Additional Relevant MeSH Terms: Central Nervous System Diseases; Nervous System Diseases; Movement Disorders
• Other Study ID Numbers: ECD001; 001 (Buy Pharma Ecza Deposu San. Tic. Ltd.); 2020/11146-0 (Other Grant/Funding Number: São Paulo Research Foundation)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The individual participant data will not be shared because they belong to a competitive team and most of the participants have less than 18 years old

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No