Massage and Cold Water Immersion on Movement Variability an Muscle Tone of Swimmers

Study Overview
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Brief Summary
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Training prescription is planned considering recovery periods to enhance performance. To assess recovery, a complexity model can be used, in which the main variable would correspond to a fractal of performance. To assess the effectiveness of post-exercise massage and cold-water immersion under a new prism of recovery by means of muscle stiffness and movement variability analysis regarding the sport-specific gesture and an experimental task of shoulder elevation in swimmers.

Detailed Description
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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.

Official Title
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Effects of Post Exercise Massage and Cold-water Immersion on Movement Variability and Muscle Stiffness in Swimmers: A Randomized Controlled Clinical Trial

Conditions
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Movement Disorders, Muscle Tone

Intervention / Treatment
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* Other: Massage
* Other: Cold water immersion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: male and female athletes between 12 and 20 years old train regularly at swimming teams 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

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Massage<br>12 minutes of effleurage and petrissage on the upper limbs administered after fatiguing exercise in the swimming pool | Other: Massage<br>* 12 minutes of effleurage and petrissage on the upper limbs<br>|
| Experimental: Cold-water immersion<br>12 minutes of cold-water immersion at the shoulder level with water temperature between 11 to 15°C | Other: Cold water immersion<br>* 12 minutes of cold water immersion at the shoulder level with water temperature between 11 to 15°C<br>|
| No Intervention: Control<br>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?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Coordination pattern | Eleven inertial sensors (XSens) will be positioned on the upper limbs, head and trunk. Data from the sensors will be extracted and processed with non linear analysis to determine the variability of the coordination pattern after fatigue and after interventions | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain numerical rating scale | Measured by a numerical rating scale ranging from 0 (nothing) to 10 (extreme) before and after the fatiguing protocol and interventions | 1 day | 
| Perception of Effort | Measured by the modified Borg scale (CR10) ranging from 0 (nothing) to 10 (extremely strong) after the fatiguing protocol and interventions | 1 day | 
| Recovery | Measured by a numerical rating scale ranging from 0 (nothing) to 10 (extreme) after the fatiguing protocol and interventions | 1 day | 
| Myotonometry | The MyotonPRO 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. Measured before and after the fatiguing protocol and interventions | 1 day | 
| Skin temperature | The temperature will be measured using an infrared thermographic camera, at the same points of myotonometry. Measured before and after the interventions | 1 day | 
| 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 | 1 day | 
| Preference | After the study the participants will be asked which of the interventions they preferred to received to recover from the fatiguing exercise | 1 day | 
| 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 before and after the fatiguing exercise and interventions | 1 day | 
| Psychological questionnaire | Participantes should rate physical and mental readiness for the exercise, fatigue, vigor and sleepness from 0 (nothing) to 10 (extreme) | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Swimming, Massage, Cryotherapy