Different Types of Cupping Therapy and Ankle Range of Motion

The Effect of Different Types of Cupping Therapy on Acute Changes in Ankle Dorsiflexion

The purpose of this study was to determine the acute effects of different manual cupping therapy protocols on ankle range of motion, compared to sham treatments, in generally healthy adults with limited ankle range of motion (i.e., ankle dorsiflexion less than 40 degrees).

Study Overview

• Status: Completed
• Conditions: Healthy
• Intervention / Treatment: Other: Static cupping; Other: Static sham cupping; Other: Dynamic cupping; Other: Dynamic sham cupping

Detailed Description

The purpose of this study was to determine the acute effects of different manual cupping therapy protocols on ankle range of motion, compared to sham treatments, in generally healthy adults with limited ankle range of motion (i.e., ankle dorsiflexion less than 40 degrees). Participants had their baseline ankle dorsiflexion measured with a digital inclinometer in a weight-bearing modified lunge position by a certified athletic trainer. Participants who were eligible for the study were then randomly assigned to one of 4 groups; 2 of which were intervention groups (i.e., dynamic cupping, static cupping) and 2 of which were sham treatments (i.e., static sham cupping, dynamic sham cupping). Each participant was blinded to the therapy they were randomized to and all received a total of 10 minutes of the cupping therapy (either actual or sham). In general, cupping therapy consisted of creating a negative pressure in four 2" diameter plastic cups placed on the gastrocnemius. Sham cups had small holes in them allowing air to leak out. Cups were also attached with adhesive tape to all participants to ensure blinding. Depending on the treatment received, participants either were asked to lie still in the prone position or perform ankle exercises during the 10 minutes while the cups were attached. Immediately after receiving treatment, participants had their ankle dorsiflexion measured again using the same procedure described for baseline measurement.

• Study Type: Interventional
• Enrollment (Actual): 49
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Michigan
    • Marquette, Michigan, United States, 49855
      • Northern Michigan University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Limited ankle dorsiflexion (less than 40 degrees of weight bearing ankle dorsiflexion at baselines)
• Never received cupping therapy prior to the study
• No lower extremity injuries in the past 6 months
• No contraindications associated with cupping therapy (e.g., deep vein thrombosis, pregnancy, bone fracture, or sunburn/rash)
• Generally healthy

Exclusion Criteria:

• Ankle dorsiflexion greater than or equal to 40 degrees during weight bearing ankle dorsiflexion at baseline
• Received cupping therapy in the past
• Has a lower extremity injury or has had a lower extremity injury in the past 6 months
• Self-reported a contraindication associated with cupping therapy (e.g., deep vein thrombosis, pregnancy, bone fracture, or sunburn/rash).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Static cupping; Negative pressure was created inside 4 plastic cups (2" diameter) placed on the gastrocnemius by drawing out air with two full pumps via a manual suction tool and participants laid in the prone position for 10 minutes while the cups stayed attached to the skin. Cups were attached to the skin with adhesive tape.	Other: Static cupping; 4 cups were placed on the gastrocnemius, negative pressure was applied and participants lay prone on a table for 10 minutes.
Experimental: Dynamic cupping; Negative pressure was created inside 4 plastic cups (2" diameter) placed on the gastrocnemius by drawing out air with two full pumps via a manual suction tool and participants laid in the prone position for 5 minutes while the cups stayed attached to the skin. Participants then completed two sets of 10 full range ankle pumps with a rest period of 30 seconds between sets (approximately 2 minutes). For the remaining 3 minutes, participants remained still in the prone position with the cups remaining attached. Cups were attached to the skin with adhesive tape.	Other: Dynamic cupping; 4 cups were placed on the gastrocnemius, negative pressure was applied and participants lay prone on a table for 5 minutes, then did ankle exercises for 3 minutes, and lastly lay prone on the table for the last 3 minutes.
Sham Comparator: Dynamic sham cupping; Negative pressure was created inside 4 plastic cups (2" diameter) placed on the gastrocnemius by drawing out air with two full pumps via a manual suction tool and participants laid in the prone position for 5 minutes while the cups stayed attached to the skin. Participants then completed two sets of 10 full range ankle pumps with a rest period of 30 seconds between sets (approximately 2 minutes). For the remaining 3 minutes, participants remained still in the prone position with the cups remaining attached. Cups were attached to the skin with adhesive tape. However, the sham cups had a small hole in them which allowed pressure to leak out.	Other: Dynamic sham cupping; 4 cups were placed on the gastrocnemius, negative pressure was applied and participants lay prone on a table for 5 minutes, then did ankle exercises for 3 minutes, and lastly lay prone on the table for the last 3 minutes. A pin hole in the cup allowed pressure to slowly leak out during the treatment.
Sham Comparator: Static sham cupping; Negative pressure was created inside 4 plastic cups (2" diameter) placed on the gastrocnemius by drawing out air with two full pumps via a manual suction tool and participants laid in the prone position for 10 minutes while the cups stayed attached to the skin. Cups were attached to the skin with adhesive tape. However, the sham cups had a small hole in them which allowed pressure to leak out.	Other: Static sham cupping; 4 cups were placed on the gastrocnemius, negative pressure was applied and participants lay prone on a table for 10 minutes. A pin hole in the cup allowed pressure to slowly leak out during the treatment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in average ankle dorsiflexion (degrees) using a digital inclinometer	Weight bearing ankle dorsiflexion measured by performing a modified lunge and bringing the knee forward as far as possible without allowing the heel to come off of the ground. A digital inclinometer was placed vertically over the tibial tuberosity and the measurement was reported as the average of three trials, in degrees.	Baseline and immediately after receiving treatment.

Collaborators and Investigators

• Sponsor: Northern Michigan University
• Investigators: Principal Investigator: Megan C Nelson, PhD, Northern Michigan University

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2022
• Primary Completion (Actual): March 1, 2023
• Study Completion (Actual): March 31, 2023

Study Registration Dates

• First Submitted: July 16, 2024
• First Submitted That Met QC Criteria: July 16, 2024
• First Posted (Actual): July 22, 2024

Study Record Updates

• Last Update Posted (Actual): July 25, 2024
• Last Update Submitted That Met QC Criteria: July 23, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Ankle dorsiflexion; Dynamic cupping; Static cupping
• Other Study ID Numbers: HS-22-1287

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No individual data will be shared, data will only be shared in aggregate form.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No