Effect of Different Techniques of Recovery in Para-athletes

Study Overview
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Brief Summary
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Para-athletes are submitted and intense efforts in training and competitions that often overlap in days and weeks. In this sense, and in the search for better brands and indexes, it is necessary to use recovery methods that allow less late muscle pain and better physical performance. Recovery methods are widely used in athletes of various modalities, however there are no studies that point out their effects on para-athletes. This highlights the need for studies on this topic. Paragliding athletes, who train at the Londrina Yacht Club, Londrina Canoeing and Rowing School, who present paraplegia after spinal cord injury, with motor level T10 or lower, without any problem of thermoregulation will participate in the study. All were male and female, with no complaints of musculoskeletal pain or history of upper limb muscle injuries in the last six months and with the same demand for training and competitions. Initially an evaluation will be performed where 1RM, VO2 max, pain, spasticity, body temperature, heart rate variability and electromyographic signal of the involved muscles will be tested. After three days they will be induced to fatigue through a protocol in the traction exercise and immediately directed to one of the 3 intervention groups: ice pack, immersion in cold water or rest. The same baseline evaluations will be repeated after 24, 48 and 72 hours. It is expected that the group submitted to immersion in cold water presents better parameters for pain and sports performance.

Detailed Description
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Athletes who agree to participate in the study will sign the ICF and will respond to the questionnaire to characterize the sample. All procedures will be carried out at the Londrina Canoeing and Rowing School, where athletes are trained. In the sequence the athlete will be submitted to the test of a maximum repetition (1RM) of the exercise of traction with the upper limbs, which is specific for canoeing. This will be performed with the athlete positioned in a decubitus position and well positioned. In the following, it will be advised to lift the bar with load determined by the athlete as adequate to carry out the movement, in case of carrying out the movement with ease and without compensations of other parts of the body the load will increase until the athlete is no longer able to perform the movement with quality, and then the maximum load determined as the one in which it was able to perform the complete movement for the last time. On the first day of collection, the maximum VO2 test will be performed, where the athlete will perform a test of 8 to 12 minutes where a progressive load will be introduced until the athlete reaches his maximum oxygen consumption and is no longer able to continue the test. After three days the athlete will return to the collection site to perform the tests in three moments: At rest (lying supine on a stretcher): HR variability VO2 Resting body temperature Assessment of spasticity by the Ashworth scale Borg Fatigue Scale. EVA pressure pain threshold (LDP) During simulation of the paddle on the K1 ergometer (figure 2), which will be held for 6 minutes at comfortable pace, where the last minute data will be used: IN G VO2 HR variability After the end of the evaluations, the athlete will be submitted to the fatigue protocol where he will be guided, to perform the maximum movements of the traction exercise with load referring to 60% of the 1RM, twice, with interval of 1 minute between them. Then it will be taken to another place, near the collection room for randomization, by means of a draw in a sealed and opaque envelope in one of the three study groups: Cold water immersion: The athlete will remain submerged in a Cryo Control - Ice Bath Systems® bathtub, which allows filtration and maintenance of constant water temperature, and shoulder blade water for 15 minutes in the water at 15 degrees Celsius. Ice pack: The athlete will remain for 20 minutes with plastic packets of 500 grams of ice each, in the region of the evaluated muscles. Control: Group in which the athlete will be instructed to remain seated in a comfortable position, at rest, for 20 minutes. The randomization and execution of the protocols will be carried out in environments that the evaluators do not have vision or access, to favor the blindness of the evaluations. After termination of the intervention protocol, the athlete will be instructed to maintain routine sleep and feeding activities with the rest of the team, but without participation in any type of training or physical activity for the next 3 days.

Official Title
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Effect of Different Techniques of Recovery After Fadiga in Para-athletes

Conditions
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Pain, Recruitment

Intervention / Treatment
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* Other: immersion
* Other: ice pack
* Other: rest


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: paraplegia after spinal cord injury, with motor level T10 or lower, without any problem of thermoregulation athletes of the modality paracanoagem, that train in the Yacht Club of Londrina, in the School of canoagem and rowing of Londrina Exclusion Criteria: cold allergies upper limb surgery in the last six months scarring or skin lesions peripheral vascular perfusion abnormalities viral conditions (such as colds or flu)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 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: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Immersion in cold water<br>The athlete will remain submerged in a Cryo Control - Ice Bath Systems® bathtub, which allows filtration and maintenance of constant water temperature, and shoulder blade water (Getto and Golden, 2013) for 15 minutes in the 15 degrees Celsius (Machado et al, 2016). | Other: immersion<br>* cold water immersion<br>|
| Active Comparator: Ice pack<br>The athlete will remain for 20 minutes with plastic packets of 500 grams of ice each, in the region of the evaluated muscles. | Other: ice pack<br>* ice packs through the body<br>|
| Sham Comparator: Control<br>Group in which the athlete will be instructed to remain seated in a comfortable position, at rest, for 20 minutes. | Other: rest<br>* seated rest<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| evolution of muscular pain | late muscle pain will be assessed at various times to detect changes caused by fatigue will be analyzed through the threshold of pressure pain, in view of the induction of pain caused to the study, the pain will be monitored at various times | pre, immediately after, after 24, 48 and 72 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| oxygen consumption | will be analyzed the percentage of maximum VO2 used for a given task by means of gas analyzer | pre, immediately after, after 24, 48 and 72 hours | 
| spasticity | by ashworth scale | pre, immediately after, after 24, 48 and 72 hours | 
| muscle recruitment | with electromyography during rowing task | pre, immediately after, after 24, 48 and 72 hours | 
| heart rate variability | by polar, during the paddling activity | pre, immediately after, after 24, 48 and 72 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sports for people with disabilities, immersion therapy, cryotherapy, physiotherapy