Clinical trial NCT05801302: Effects of Foam Rolling on the Plantar Flexors' Properties
Official title: Acute Effects of Different Foam Rolling Protocols on the Plantar Flexors' Musculotendinous Properties in Healthy Individuals
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Foam Roller
Achilles Tendon
Lead sponsor: Federal University of Rio Grande do Sul
Sponsor class: OTHER
First posted: 2023-04-06
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Maximum age (years): 35
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: BASIC_SCIENCE

Brief summary: Self-massage is a set of therapeutic techniques performed by the individual using instruments such as a foam roller (i.e., foam rolling \[FR\]). This technique has been used in rehabilitation to recover myofascial dysfunctions and in physical/sports training, to improve performance in functional and sports activities. Possible changes in the muscle's and tendon's mechanical properties may help to explain the FR effects, however, the dose-response relationship is not clear acutely. Furthermore, body composition also seems to influence the pressure applied to the different tissues during FR, since it can attenuate the forces applied on the tissues. Therefore, the aim of this study is to verify the acute effects of different FR volumes on the plantar flexors' musculotendinous properties in healthy individuals. Twenty healthy subjects (male and female) aged between 18-35 years will perform three different FR conditions: FR90 (3x30s), FR180 (3x60s), and a control condition (CTRL; without the application of any intervention) with a seven-day wash-out period. The Achilles tendon morphological, mechanical, and material properties, medial gastrocnemius passive muscular stiffness, plantar flexors' muscle architecture, and the adipose tissue's thickness, skin temperature and the jump height (assessed during the unilateral countermovement jump) will be obtained. Assessments will be carried out before and immediately after the FR application in the different conditions. Descriptive statistics (mean, standard deviation, and standard error) will be used to present the results. The normality and sphericity of the data will be evaluated using the Shapiro-Wilk and Mauchly tests, respectively. A two-way ANOVA (condition \[FR90, FR180, and CTRL\] and moments \[pre- and post-intervention\]) will be used to compare the results. A post-hoc Bonferroni test will be used to find possible differences. A Pearson product-moment correlation test (parametric data) or a Spearman correlation test (non-parametric data) will be used to verify the association between the adipose tissue's thickness and the evaluated parameters. The effect size (Cohen's d) of each condition will be obtained. Responsiveness to conditions (FR90, FR180, and CTRL) will be determined using the typical error.

Detailed description: Self-massage is a set of therapeutic technique performed by the individual using instruments such as a foam roller (i.e., foam rolling \[FR\]). This technique has been used in rehabilitation to recover myofascial dysfunctions and in physical/sports training, to improve performance in functional and sports activities. Possible changes in the muscle's and tendon's mechanical properties may help to explain the FR effects. Although some studies have found a decreased muscle stiffness after FR intervention, other studies have reported no changes in muscle stiffness. Furthermore, a single study investigated the FR effects on the tendon and found no stiffness changes post-intervention. The between-studies methodological procedures heterogeneity, especially the different FR protocols (e.g., pressure-volume) may partially justify conflicting results. However, the dose-response relationship is not clear acutely. Furthermore, body composition also seems to influence the pressure applied to the different tissues during FR. Therefore, the aim of this study is to verify the acute effects of different FR volumes on the plantar flexors' musculotendinous properties in healthy individuals. Twenty healthy subjects (male and female) aged between 18-35 years will perform three different FR conditions: FR90 (3x30s), FR180 (3x60s), and a control condition (CTRL; without the application of any intervention) with a seven-day wash-out period. The weight-bearing during the FR application will be obtained through ground reaction forces, measured through force platform. The Achilles tendon morphological properties (length and cross-sectional area) will be evaluated using ultrasonography. In order to evaluate the mechanical (stiffness, force, and elongation) and material (Young's modulus, stress, and strain) properties, three maximum voluntary isometric contractions (MVIC) will be performed in a plantar flexion ramp in the isokinetic dynamometer with ultrasonography. The tendon force will be corrected by the tibialis anterior coactivation and adjusted by the tendon displacement caused by joint rotation during MVIC. The tendon elongation will be monitored during CMVIC using the ultrasound. The medial gastrocnemius muscle stiffness will be calculated by the variation in a passive dorsiflexion torque (isokinetic dynamometer) and the variation in the muscle length (ultrasound). The adipose tissue's thickness also will be obtained from ultrasound. The skin temperature will be evaluated by a thermographic camera to investigate possible post-intervention changes. The unilateral countermovement jump performance will be evaluated by 2D kinematic data measurements, using a video camera. Assessments will be carried out before and immediately after the FR application in the different conditions. Descriptive statistics (mean, standard deviation, and standard error) will be used to present the results. The normality and sphericity of the data will be evaluated using the Shapiro-Wilk and Mauchly tests, respectively. A two-way ANOVA (condition \[FR90, FR180, and CTRL\] and moments \[pre- and post-intervention\]) will be used to compare the results. A post-hoc Bonferroni test will be used to localize possible differences. A Pearson product-moment correlation test (parametric data) or a Spearman correlation test (non-parametric data) will be used to verify the association between the adipose tissue's thickness on the evaluated parameters, classified as none (0.0), weak (0.1-0.3), moderate (0.4-0.6), strong (0.7-0.9), or perfect (1.0). The effect size (Cohen's d) of each condition will be obtained, classified as small effect size (\< 0.20); moderate effect size (0.20-0.50); or large effect size (\>0.80). Responsiveness to conditions (FR90, FR180, and CTRL) will be determined using the typical error.

Eligibility criteria: Inclusion Criteria:

* Both male and female;
* Age between 18 and 35 years;
* Not involved in strength training for lower limbs;
* Not using foam rolling regularly;
* Only women using hormonal contraceptive pills will be included in order to standardize the hormonal cycle.

Exclusion Criteria:

* History in the last year of musculoskeletal injuries in the lower limbs that represent a contraindication for the execution of maximum exercises or that may interfere with performance during evaluations and treatment sessions (Achilles tendinopathy, ligament ruptures with or without surgical procedures, recent cases of muscle injury or sprain of ankle);
* Presenting with inflammation, acute pain or delayed muscle pain on the day of assessment;
* Performing some type of high-intensity physical activity for up to 72 hours before assessments;
* Ingestion of some type of analgesic medication, alcohol or caffeine in the last 48 hours before the evaluations;
* Have respiratory or cardiovascular conditions considered a risk factor or limiting to maximum tests;
* Use of anabolic steroid supplements.

Primary outcomes:
measure: Changes in Achilles tendon stiffness
timeFrame: Change from baseline at immediately after intervention
measure: Changes in medial gastrocnemius passive muscular stiffness
timeFrame: Change from baseline at immediately after intervention
measure: Changes in unilateral countermovement jump height
timeFrame: Change from baseline at immediately after intervention
Secondary outcomes:
measure: Changes in tendon Young's modulus
timeFrame: Change from baseline at immediately after intervention
measure: Changes in Achilles tendon cross-sectional area
timeFrame: Change from baseline at immediately after intervention
measure: Changes in Achilles tendon length
timeFrame: Change from baseline at immediately after intervention
measure: Changes in muscle Architecture
timeFrame: Change from baseline at immediately after intervention
measure: Changes in skin temperature
timeFrame: Change from baseline at immediately after intervention
Other outcomes:
Locations:
city: Porto Alegre
country: Brazil
facility: Federal University of Rio Grande do Sul
state: RS
Study officials:
affiliation: Federal University of Rio Grande do Sul
name: Jeam Geremia, Dr
role: STUDY_DIRECTOR
References: