Efficacy of the Most Commonly Used Physiotherapeutic Treatments for Acute Lower Limb Fatigue in Athletes

August 9, 2024 updated by: GEMA LEÓN BRAVO, Clinica Gema Leon

Acute fatigue is the inability to generate a required or expected level of force or exercise intensity, whether or not preceded by previous exercise. It is an important risk factor in overuse injuries. It is multifactorial in nature and its mechanisms of formation are imprecise. This type of fatigue can affect both the peripheral level, generating neuromuscular or peripheral fatigue, and the central level, generating central fatigue Objective: To study several physiotherapeutic protocols, analyzing the degree of effectiveness of each one for the recovery of acute fatigue in athletes. Design: Prospective randomized experimental study with 4 groups of physiotherapeutic protocols suitable in acute fatigue recovery. Participants: Presentation of 80 patients treated with 4 therapeutic protocols, equally divided and purposely sexed. The four protocols were divided into: Active recovery (n=20) hydrotherapy (n=20) massage (n=20) and compression (n=20) for 4 weeks of treatment. Intervention: Active recovery protocols (group 1) hydrotherapy protocol (group 2) massage protocol (group 3) and comprehension protocol (group 4).

Keywords: Lower limbs, physiotherapy, athlete, biomechanics, protocol.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The etiology of injury in sport is multifactorial, generated by both intrinsic and extrinsic factors. There is evidence that supports that the management and handling of loads is the factor that generates the greatest risk of injury and that not respecting the load-recovery balance can lead to an accumulation of fatigue resulting in poor training adaptation which leads to increased risk of injury. From a physiological approach, fatigue is defined as a functional failure of the organism which, due to excessive energy expenditure and depletion of substrates necessary for energy production, leads to a decrease in performance.

Acute fatigue is the inability to generate a required or expected level of exercise force or intensity, whether or not preceded by previous exercise. Acute fatigue is an important risk factor in overuse injuries. It is multifactorial in nature and its mechanisms of formation are imprecise. This type of fatigue can affect both the peripheral level, generating neuromuscular or peripheral fatigue, and the central level, generating central fatigue. Peripheral or neuromuscular fatigue is the result of altered musculoskeletal homeostasis due to a limitation or failure of one or more motor unit processes, producing a dysfunction in the contraction process. Central fatigue is an involuntary failure in brain function or nerve impulse conduction, resulting in impaired transmission from the central nervous system (CNS) and impaired motor axon recruitment. One of the main factors associated with central fatigue is the alteration of synthesis and activity of some neurotransmitters.

Elite athletes push their training to the limit in order to maximize their performance. This generates muscle damage that results in a breakdown of structural proteins of muscle fibers and connective tissues, causing tissue inflammation, Delayed Onset Muscle Soreness (DOMS) and an increase in perceived fatigue. To maximize an athlete's ability to perform, it is not only the training that must be addressed, but also the balance between training and recovery. This prevents maladaptation to physiological and psychological stresses induced by the load. Therefore, it is important for the athlete to optimize the recovery period to reduce the risk of injury.

The purpose of this research is to demonstrate the efficacy of various physiotherapeutic protocols, analyzing the degree of effectiveness in each of these for recovery from acute fatigue in athletes.

Study Type

Interventional

Enrollment (Actual)

80

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Spain
    • Andalucía
      • Córdoba, Andalucía, Spain, 14011
        • Gema León Physiotherapy and Rehabilitation Clinic

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 25 years (Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Active athletes
  • Presentation of typical clinical signs of acute fatigue in one of the two lower limbs
  • Positive diagnosis of acute fatigue

Exclusion Criteria:

  • Not compatible with age range
  • Healthy athletes
  • Diagnosed injuries other than acute fatigue

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Group 1: Compression technique
20 participants make up the compression technique group.
Diagnostic test: State-Trait Anxiety Questionnaire

The scale measures ordinally (1 to 5) the values observed during exposure to anxiety patterns during exercise, such as higher repetitions, greater weight gain or longer exercise duration, as follows:

  1. Not at all
  2. Little
  3. Sometimes
  4. Almost always
  5. Always
Other Names:
  • STAI
Diagnostic test: Rating of Perceived Exertion

The scale measures in ordinal form (1 to 6) the perceived effort during the exercise as follows:

  1. No pain
  2. Little pain
  3. Moderate
  4. Severe
  5. Very strong
  6. Unbearable
Other Names:
  • RPE
Diagnostic test: Motor coordination tests

The motor coordination tests are divided into three:

  1. Jumping with 2 feet together.
  2. Throwing 2 balls from a given distance and space.
  3. Proprioception turns
Procedure: Physiotherapeutic intervention
Participants received one session per week, until a total of 20 sessions were completed: Group 1 (n=20) received the muscle compression treatment. Group 2 (n=20) received the manual massage treatment. Group 3 (n=20) received the hydrotherapy treatment and group 4 (n=20) received the active recovery treatment.
Other: Data Analysis
The usual descriptive parameters (mean and standard deviation) of the sample were calculated. The distribution and analysis of the other data were performed by means of a nonparametric test (Mann-Whitney U test) comparing the groups. A confidence level of 95% was established, considering a value of p<0.05 as statistically significant.
Active Comparator: Group 2: Massage techniques
20 participants make up the massage technique group.
Diagnostic test: State-Trait Anxiety Questionnaire

The scale measures ordinally (1 to 5) the values observed during exposure to anxiety patterns during exercise, such as higher repetitions, greater weight gain or longer exercise duration, as follows:

  1. Not at all
  2. Little
  3. Sometimes
  4. Almost always
  5. Always
Other Names:
  • STAI
Diagnostic test: Rating of Perceived Exertion

The scale measures in ordinal form (1 to 6) the perceived effort during the exercise as follows:

  1. No pain
  2. Little pain
  3. Moderate
  4. Severe
  5. Very strong
  6. Unbearable
Other Names:
  • RPE
Diagnostic test: Motor coordination tests

The motor coordination tests are divided into three:

  1. Jumping with 2 feet together.
  2. Throwing 2 balls from a given distance and space.
  3. Proprioception turns
Procedure: Physiotherapeutic intervention
Participants received one session per week, until a total of 20 sessions were completed: Group 1 (n=20) received the muscle compression treatment. Group 2 (n=20) received the manual massage treatment. Group 3 (n=20) received the hydrotherapy treatment and group 4 (n=20) received the active recovery treatment.
Other: Data Analysis
The usual descriptive parameters (mean and standard deviation) of the sample were calculated. The distribution and analysis of the other data were performed by means of a nonparametric test (Mann-Whitney U test) comparing the groups. A confidence level of 95% was established, considering a value of p<0.05 as statistically significant.
Active Comparator: Group 3: Hydromassage
20 participants make up the hydromassage technique group.
Diagnostic test: State-Trait Anxiety Questionnaire

The scale measures ordinally (1 to 5) the values observed during exposure to anxiety patterns during exercise, such as higher repetitions, greater weight gain or longer exercise duration, as follows:

  1. Not at all
  2. Little
  3. Sometimes
  4. Almost always
  5. Always
Other Names:
  • STAI
Diagnostic test: Rating of Perceived Exertion

The scale measures in ordinal form (1 to 6) the perceived effort during the exercise as follows:

  1. No pain
  2. Little pain
  3. Moderate
  4. Severe
  5. Very strong
  6. Unbearable
Other Names:
  • RPE
Diagnostic test: Motor coordination tests

The motor coordination tests are divided into three:

  1. Jumping with 2 feet together.
  2. Throwing 2 balls from a given distance and space.
  3. Proprioception turns
Procedure: Physiotherapeutic intervention
Participants received one session per week, until a total of 20 sessions were completed: Group 1 (n=20) received the muscle compression treatment. Group 2 (n=20) received the manual massage treatment. Group 3 (n=20) received the hydrotherapy treatment and group 4 (n=20) received the active recovery treatment.
Other: Data Analysis
The usual descriptive parameters (mean and standard deviation) of the sample were calculated. The distribution and analysis of the other data were performed by means of a nonparametric test (Mann-Whitney U test) comparing the groups. A confidence level of 95% was established, considering a value of p<0.05 as statistically significant.
Active Comparator: Group 4: Active recovery technique.
20 participants make up the active recovery technique group.
Diagnostic test: State-Trait Anxiety Questionnaire

The scale measures ordinally (1 to 5) the values observed during exposure to anxiety patterns during exercise, such as higher repetitions, greater weight gain or longer exercise duration, as follows:

  1. Not at all
  2. Little
  3. Sometimes
  4. Almost always
  5. Always
Other Names:
  • STAI
Diagnostic test: Rating of Perceived Exertion

The scale measures in ordinal form (1 to 6) the perceived effort during the exercise as follows:

  1. No pain
  2. Little pain
  3. Moderate
  4. Severe
  5. Very strong
  6. Unbearable
Other Names:
  • RPE
Diagnostic test: Motor coordination tests

The motor coordination tests are divided into three:

  1. Jumping with 2 feet together.
  2. Throwing 2 balls from a given distance and space.
  3. Proprioception turns
Procedure: Physiotherapeutic intervention
Participants received one session per week, until a total of 20 sessions were completed: Group 1 (n=20) received the muscle compression treatment. Group 2 (n=20) received the manual massage treatment. Group 3 (n=20) received the hydrotherapy treatment and group 4 (n=20) received the active recovery treatment.
Other: Data Analysis
The usual descriptive parameters (mean and standard deviation) of the sample were calculated. The distribution and analysis of the other data were performed by means of a nonparametric test (Mann-Whitney U test) comparing the groups. A confidence level of 95% was established, considering a value of p<0.05 as statistically significant.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
State-Trait Anxiety Questionnaire (STAI)
Time Frame: five months
The range or index of anxiety perceived during the exam and the ability to tolerate anxious moments are evaluated.
five months
Rating of Perceived Exertion (RPE)
Time Frame: five months
The range or rate of perceived exertion during the scan is evaluated.
five months
Scale Countermovement jump (CMJ)
Time Frame: five months
The range or index of neuromuscular performance during the scan is evaluated.
five months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of participants in each physical therapy application
Time Frame: five months

Five reviews were carried out corresponding to the five months of treatment. During these five months, the participants received one session per week, until a total of 20 sessions were completed:

  • Group 1 (n=20) received the muscle compression treatment.
  • Group 2 (n=20) received the manual massage treatment.
  • Group 3 (n=20) received the hydrotherapy treatment.
  • Group 4 (n=20) received the active recovery treatment.
five months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Clinica Gema Leon

Investigators

  • Principal Investigator: Gema León Bravo, Physiotherap, Gema León Physiotherapy and Rehabilitation Clinic
  • Study Chair: Rafael Arenas Quiles, Physiotherap, Universidad de Córdoba

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 6, 2021

Primary Completion (Actual)

April 21, 2022

Study Completion (Actual)

April 30, 2022

Study Registration Dates

First Submitted

November 6, 2021

First Submitted That Met QC Criteria

December 7, 2021

First Posted (Actual)

December 22, 2021

Study Record Updates

Last Update Posted (Actual)

August 12, 2024

Last Update Submitted That Met QC Criteria

August 9, 2024

Last Verified

August 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ART-GLB-ACUTE FATIGUE

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The request for the data will be studied and considered upon prior and justified request.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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