Trans-cranial electric stimulation, endomassage and magnetic therapy to facilitate post-injury rehabilitation in elite sports
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Dr.Biol., Professor J.V. Koryagina1
PhD G.N. Ter-Akopov1
PhD S.V. Nopin1
PhD L.G. Roguleva1
E.V. Kostyuk1
1North-Caucasian Federal Research and Clinical Center of the Federal Medical-Biological Agency, Yessentuki
Keywords: athletes, rehabilitation, recovery, trans-cranial electric stimulation, endomassage, magnetic therapy.
Introduction. The problem of optimization of the body’s functional state during intense muscular activity is still the most burning one in sports physiology. Physiotherapy based on natural and artificially created physical factors has a significant physiological impact on the body and does not have any side effects.
Objective of the study was to develop and test benefits of the new trans-cranial electric stimulation (TES) method, endomassage and magnetic field therapy to facilitate the post-injury rehabilitation in elite sports.
Methods and structure of the study. The effects of TES on physical working capacity and urgent rehabilitation of the athletes were studied using a treadmill graded exercise test accompanied by ergospirometry and analysis of the dynamics of urgent rehabilitation. This included 3 tests conducted with a 3-day interval: 1st test – maximal load test without the use of the TES method, 2nd test – 20-min TES session (current intensity – 2-3 mA) followed by the maximal load test, 3rd test – 20-min TES session during the urgent rehabilitation period (current intensity – 2-3 mA).
The study involved 42 athletes aged 18–25 years having different sport qualifications (CMS, MS, MSIC) and involved in different sports (track and field athletics, fencing, and volleyball).
The load testing was performed using the ergospirometric workstation SCHILLER (Switzerland) and H/P/COSMOS treadmill (Germany) as recommended by the protocol Astrand [1]. We recorded the test execution time, heart rate, O2 and CO2 contents in the exhaled air at the end of each step of load testing. The same indicators were recorded every minute of urgent rehabilitation (for 20 min). The athletes’ functional state was rated using the diagnostic system ESTECK System Complex (LG Technology, USA).
The effects of endomassage and magnetic field therapy on physical working capacity and urgent rehabilitation of the athletes were studied using the Bosco repeated jumps test [2]. The test consists in performing consecutive jumps for 60 sec. The following parameters were analyzed: level of fatigue, maximal take-off force before the jump; for each 15-sec period of jumping: jumping power, specific jumping power, average jump height, maximal jump height, number of jumps per period. The testing was performed on the tensodynamometric platforms of the BTS Motion System.
The testing was carried out three times on a daily basis: 1st test – without the use of EM and magnetic field therapy; 2nd test – the test followed by endomassage and magnetic field therapy during the urgent rehabilitation period; 3rd test – endomassage and magnetic field therapy followed by the test.
The endomassage and magnetic field therapy procedure was carried out using the MANTIS MR991 device, in particular, the Mini DES handpiece designed to treat the lower limbs (duration of the procedure – 20 min, rotation speed of the handpiece rollers – 70 rpm, pulsed suction frequency – 40-45, pulsed suction force – 60-70).
The statistical data processing was made using the Statistica 13.0 software and implied determination of the standard descriptive statistics parameters (mean value, non-sampling error). To assess the significance of differences in the indicators the non-parametric Wilcoxon test was used.
The impact of the TES method on physical working capacity and urgent rehabilitation of athletes. During the maximal load treadmill test without the use of the TES method, the maximum execution time was 11.2±0.7 min. During the test with the use of the TES method, the maximum execution time increased significantly and amounted to 12.4±0.7 min (p≤0.004). The analysis of the heart rate (HR) values during the test with and without the use of the TES method showed that the TES session prior to the load testing leads to a significant decrease in the HR values at the first 4 steps of load testing and, therefore, to the economization of the functions of the cardiovascular system.
In the 1st loading test (without the use of the TES method), the double product index equaled 247.5±12.4 c.u., in the 2nd one – 281.7±7.8 c.u. The use of the TES method prior to physical exercise also contributed to an increase of the chronotropic cardiac reserve index, which in the 1st test amounted to 110.5±7.4%, and in the 2nd one – to 133.9±10.0%. Thus, the TES session conducted immediately prior to physical exercise results in the improvement of physical working capacity, coupled with energy cost reduction, economization of the functions of the cardiovascular and respiratory systems, as well as an increase of the myocardial functionality during work.
The analysis of the dynamics of changes in the HR values during urgent rehabilitation after the maximal load test with and without the use of the TES method showed that TES helps to accelerate HR recovery, statistically significantly during the 1st (p<0.02), 2nd (p<0.05), 3rd (p<0.05), 4th (p<0.05), 8th (p<0.05), 9th (p<0.05), and 10th (p<0.05) min of urgent rehabilitation. The analysis of the dynamics of changes in the oxygen consumption (see Figure) and carbon dioxide emission during the daily urgent rehabilitation after exercise with and without the use of the TES method revealed that the use of the TES method during urgent rehabilitation after the maximal load treadmill test contributes to an increase in the oxygen consumption and carbon dioxide emission from the 2nd to the 8th min of urgent rehabilitation, which indicates a more active liquidation of the oxygen debt during this period.
The analysis of the heart rate variability (HRV) revealed that the use of the TES method during urgent rehabilitation after the maximal load treadmill test accelerates HR recovery, reduces the spectrum power within the low-frequency range and the ratio between the low- and high-frequency components of HRV, decreases the tension index. The hemodynamic indicators testify to the improvement in the left ventricle function, and a decrease in the stiffness of the small and medium caliber arteries.
Figure
Dynamics of oxygen consumption (VO2, l/min) during urgent rehabilitation after maximal load treadmill test with and without the use of TES method
The effects of endomassage and magnetic field therapy on physical working capacity and urgent rehabilitation of athletes. The comparative analysis of the data obtained before and after the procedure of mechanical endomassage and magnetic field therapy showed a significant increase in the power (from 875.58±105.23 to 987.24±85.10 W; p<0.05) and specific power (from 11.66±1.59 to 13.04±1.05 W; p<0.05) of the leg muscles, medium (from 0.138±0.016 to 0.172±0.019 m; p<0.05) and maximum jump height (from 0.168±0.017 to 0.200±0.018 m; p<0.05) after endomassage and magnetic field therapy (3rd test) during the 4th interval of the Bosco repeated jumps test (i.e. from the 45th to the 60th sec of jumping). The fatigue index decreased statistically significantly (from 1.87±0.18 to 1.36±0.08; p<0.05), thus indicating an increase in the strength endurance of the leg muscles of the athletes. The study of the effects of endomassage and magnetic field therapy, conducted for 20 min during urgent rehabilitation after the repeated jumps test, did not reveal any statistically significant differences in the indices of electroneuromyography and rheovasography in the athletes. To improve the parameters of the neuro-muscular activity and blood circulation in the athletes, it is necessary to conduct at least 5 endomassage and magnetic field therapy procedures for 40 minutes each.
The use of endomassage and magnetic field therapy in post-injury rehabilitation of athletes. The effects of endomassage and magnetic field therapy in post-injury rehabilitation of the athletes were studied during the course of procedures conducted using the MANTIS MR991 device, in particular the VIXO handpiece. We used punctate analgesia in the professional mode: 10 min in the punctate suction mode (pulsed suction power - 100, pulsed suction frequency - 60-70) and 10 min in the magnetic field therapy mode using Dolobene gel. The punctate analgetic impact was exerted on the areas where the Achilles tendon connects the gastrocnemius and soleus muscles to the calcaneal tuberosity. The treatment course included 5-7 procedures.
The study of the functional state of the muscular and articular apparatus of the ankle joint was carried out using the Contrex MG device. We evaluated the work of the flexor and extensor muscles of the ankle joint of the right and left leg: maximum torque (Nm), maximum angle (о), work, fatigue (J/s), average amount of work done (J), and average power (W). The pain syndrome intensity was assessed on a standard point scale.
The comparative analysis of the data obtained before and after the course of procedures to exert the punctuate analgetic impact showed that after the course almost all studied indicators of the functional state of the muscular and articular apparatus of the ankle joint - flexor and extensor muscles of the right and left legs improved statistically significantly.
The evaluation of the pain syndrome intensity (in points) in the athletes’ ankle joint showed its significant decrease from 6.4±1.1 to 2.4±1.2 points (p<0.0004).
Conclusion. The use of the TES method in elite sports contributes to the growth of the cardiovascular and respiratory system functionality rates, maximum functional capacities of the body (TES session lasting 20-30 min, current intensity - 2-3 mA); acceleration of the daily urgent restoration of the functional state of the cardiovascular system (20-min TES session during urgent rehabilitation, current intensity - 2-3 mA); phased recovery of the psychofunctional state under increased physical and psycho-emotional loads, prevention of overstress and overfatigue (TES course, duration - 30 min, 7-10 procedures, current intensity - 2-3 mA).
The combined use of endomassage and magnetic field therapy was also found beneficial for elite sports as verified by the sample progress in the speed-strength and strength endurance test indices (2-3 procedures of endomassage and magnetic field therapy, duration - 20 min, speed of rotation of the handpiece rollers – 70 rpm, pulsed suction frequency – 40-45, pulsed suction force – 60-70); improved musculoskeletal and neuromuscular system functionality (5 procedures of endomassage and magnetic field therapy, duration – 40 min, speed of rotation of the handpiece rollers - 70 rpm, pulsed suction frequency – 40-45, pulsed suction force – 60-70); phased rehabilitation and effective prevention of the fatigue-related injuries and intensive-work-related musculoskeletal system disorders (5 procedures of EM and magnetic field therapy, duration – 40 min, speed of rotation of the handpiece rollers – 70 rpm, pulsed suction frequency – 40-45, pulsed suction force – 60-70); and post-injury rehabilitation of the athletes with reduction of pains and faster recovery process (in the punctuate analgesia mode: 10 min, in the punctuate suction mode (pulsed suction force – 100, pulsed suction frequency – 60-70) and 10 min in the magnet field therapy mode using Dolobene gel).
The present study was carried out in accordance with the state applied research contract No. 129.005.18.14 of April 2, 2018, by FSBI North-Caucasian Federal Research and Clinical Center of the Federal Medical-Biological Agency of Russia: “Development and substantiation of the TES method, EM and magnetic fields therapy during recovery and rehabilitation of athletes in elite sports" (code "Kranio-18").
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Corresponding author: koru@yandex.ru
Abstract
Objective of the study was to develop and test benefits of new transcranial electric stimulation, endomassage and magnetic field therapy to facilitate the post-injury rehabilitation in elite sports.
The new model testing experiment showed benefits of the transcranial electric stimulation method for elite sports as verified by the growth of the cardiovascular and respiratory system functionality rates; faster rehabilitation of the cardiovascular system functions; phased rehabilitation of the mental and physical fitness; and effective prevention of the overstress and fatigue. The endomassage and magnetic field therapy were also found beneficial for elite sports as verified by the sample progress in the speed-strength and strength test indices; improved musculoskeletal and neuromuscular system functionality; phased rehabilitation and effective prevention of the fatigue-related injuries and intensive-work-related musculoskeletal system disorders; and post-injury rehabilitation with reduction of pains and faster recovery process.